Methods and Findings in Experimental and Clinical Pharmacology
Vol. 25, Suppl. A, 2003
ISSN 0379-0355
Copyright 2003 Prous Science, S.A.
CCC: 0379-0355/2003
http://www.prous.com

Glatiramer Acetate and Multiple sclerosis

J.A. García Merino

Jefe de Sección de Neurología y Director del Laboratorio de Neuroinmunología, Clínica Puerta de Hierro; Profesor Asociado de Neurología, Universidad Autónoma de Madrid, Madrid, Spain

Glatiramer acetate, formerly known as copolymer I, is a result of a synthetic mixture of four amino acids. It is used as a daily subcutaneous injection of 20 mg. It was approved in Spain in 2002 for the treatment of ambulatory patients with multiple sclerosis with at least two relapses in the previous three years. Efficacy data came from several clinical trials, the most important of which was carried out with 251 patients over a period of 2 years. Results from this study showed that treatment reduced the relapse rate by 29%. A further study with 239 patients showed this medication to reduce the activity of demyelinating lesions in the central nervous system, including those suggesting axonal damage.

Several mechanisms of action have been suggested to explain the therapeutic benefit of glatiramer acetate: interference with T-cell activation by competition with myelin basic protein, generation of regulatory cells in the nervous parenchyma, and induction of neuroprotective substances.

For the clinician, glatiramer acetate is an option to treat active multiple sclerosis, either as initial therapy or as an alternative for patients who cannot continue taking interferon b-because of unacceptable side effects or lack of efficacy associated with neutralizing antibodies. In summary, glatiramer acetate has demonstrated a clear effectiveness in reducing the relapse rate in multiple sclerosis, within the range observed for b interferons (one-third reduction, approximately). Compared to interferons, clinical data and neuroimaging studies suggest that the beneficial effects of this drug may appear later; its mechanisms of action and the side effect profile are also different.

Methods and Findings in Experimental and Clinical Pharmacology Vol. 25, Suppl. A, 2003
ISSN 0379-0355 Copyright 2003 Prous Science, S.A. CCC: 0379-0355/2003 http://www.prous.com