How the ABC Medications Target Multiple Sclerosis
- Wednesday, August 12, 2009, 10:19
- Multiple Sclerosis
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- Dick:
- Dr. Skeen, could you tell us more about the ABC medications – Avonex, Betaseron, and Copaxone – and how they each target multiple sclerosis?
- Dr. Skeen:
- There are five things that the various scientific studies have looked at to assess whether these drugs work for MS patients, which help us understand whether we should be on these drugs and perhaps which drugs we should choose. So, I’ve been asking patients to think on their own, and I’d ask our audience to do that. Obviously these are very interrelated aspects, but which of those things are more important to them if the medicine could only do one thing? Would they want it to…
- Reduce the number of flare-ups,
- Reduce MRI changes,
- Reduce progressive physical disability that occurs in MS,
- Reduce progressive cognitive decline, or
- Reduce progressive brain atrophy?
And interestingly, the number one factor that folks with MS have said they want the drug to do is decrease the progressive disability in MS. In fact, 48 percent — that’s the exact number I have — of folks say that that’s the most important thing in MS. That’s actually not a surprise to me. That’s exactly what I would say is the most important thing. And the second highest factor is cognitive decline: 31 percent say that cognitive decline is the most important thing. So, roughly 75 percent of the folks with MS agree that although they don’t want relapses, don’t want MRI changes to progress and don’t want atrophy, what’s more important to them is how MS affects their life. And I think that’s the obvious answer, but I was happy when I think that my thoughts agreed with folks living with MS.“Roughly 75 percent of the folks with MS agree that what’s more important to them in starting treatment is how MS affects their life.” - Dick:
- It seems that it wouldn’t be easy to look at those five points and choose which is the most important to you.
- Dr. Skeen:
- It’s really not, and some of the folks have a very difficult time rating them one through five. Many of them say, “Well, all of these things are important to me.” And I don’t mean to make it artificial. What I’ve really just tried to assess is of those things, which are most important, and to get people to think about what it is we’re trying to accomplish with the medication.
- Dick:
- What’s been your experience with the ABC medications and how they impact these five areas that you’ve mentioned?
- Dr. Skeen:
- If we take first the number of exacerbations, it’s very clear that all of these medicines reduce the number of relapses or exacerbations that occur in multiple sclerosis. And if you look at the very good scientific studies, it’s very clear to me that the drugs in that respect are more alike than they are different. I always ask MS experts, “If I have a patient who takes any one of these three drugs regularly for two years, how will it affect their relapses?” The answer to that question is very simple: it reduces the exacerbations or the flare-ups by about a third. So, if you take any one of these drugs and in a given period of time you normally would have had three flare-ups, we would expect you to have two. And that’s really the most solid answer. If you look at shorter periods of time, you can find different numbers, but the reality is MS is a chronic disease. If we want to know what happens, we really have to look at it over a significant period of time.
The second point, you know, what happens with the MRI scans? What I would emphasize is that all three medicines do have an impact on the MRI scans, and that impact is, I would say, very substantial. In one study, it reduced the number of new lesions by 89 percent or new spots on the MRI. So, I think the summary is that when it comes to the MRI changes, the ABC drugs – Avonex, Betaseron, and Copaxone – are very effective.
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