At least 30 per cent of people with relapsing-remitting MS do not respond well to first-line disease-modifying treatments (DMTs) in the first year.
The most common reasons why physicians change an MS patient’s medication are:
- lack of efficacy or suboptimal response
- intolerable drug-induced adverse events
- the development of neutralizing antibodies blocking the activity of the drug
There are no accepted criteria to guide physicians when considering whether to change first-line disease-modifying treatments, and such decisions are generally based on the individual’s judgment.
However, several studies have shown a clinical benefit in changing from one class of first-line disease-modifying treatment to another, or to second-line treatments. In particular, these studies suggest that patients with relapsing-remitting MS who do not benefit from interferon may benefit from switching to glatiramer acetate.
The COPTIMIZE study assessed the disease course of patients who had switched to glatiramer acetatefrom another DMT. It was a two-year observational study carried out among 672 patients from 148 centres in 19 countries.
Over a two-year period, 72.7 per cent of patients who converted to glatiramer acetatewere relapse-free, and a large proportion of patients had no confirmed disability progression. Furthermore, patients improved significantly when measured for fatigue, quality of life, depression and cognition.
The results show that switching patients with relapsing-remitting MS to glatiramer acetate(when interferon cannot be used or is ineffective), is associated with positive treatment outcomes.