Five Approved Long-Term Treatments for MS
| Drug | Type | Side Effects | How Administered | Notes |
|---|---|---|---|---|
| Betaseron | Interferon beta-1b* (immune system modulator with antiviral properties) | Flu-like symptoms, injection-site skin reaction, blood count and liver test abnormalities | 250 micrograms taken via subcutaneous injections every other day | Side effects may be prevented and/or managed effectively through various treatment strategies; side effect problems are usually temporary. |
| Avonex | Interferon beta-1a* (immune system modulator with antiviral properties) | Flu-like symptoms and headache | 30 micrograms taken via weekly intermuscular injections | Side effects may be prevented and/or managed effectively through various treatment strategies; side effect problems are usually temporary. |
| Rebif | Interferon beta-1a* (immune system modulator with antiviral properties) | Flu-like symptoms, injection-site skin reaction, blood count and liver test abnormalities | 44 micrograms taken via subcutaneous injections three times weekly | Side effects may be prevented and/or managed effectively through various treatment strategies; side effect problems are usually temporary. |
| Copaxone | Synthetic chain of four amino acids found in myelin (immune system modulator that blocks attacks on myelin) | Injection-site skin reaction as well as an occasional systemic reaction - occurring at least once in approximately 10 percent of those tested | 20 milligrams taken via daily subcutaneous injections | Systemic reactions occur about five to 15 minutes following an injection and may include anxiety, flushing, chest tightness, dizziness, palpitations, and/or shortness of breath. Usually lasting for only a few minutes, these symptoms do not require specific treatment and have no long-term negative effects. |
| Novantrone | Antineoplastic agent (immune system modulator and suppressor) | Usually well tolerated; side effects include nausea, thinning hair, loss of menstrual periods, bladder infections, and mouth sores; additionally, urine and whites of the eyes may turn a bluish color temporarily | IV infusion once every 3 months (for two to three years maximum) | Novantrone carries the risk of cardiotoxicity (heart damage) and may not be given beyond two or three years. People undergoing treatment must have regular testing for cardiotoxicity, white blood cell counts, and liver function. Novantrone was studied in combination with large IV doses of steroids. Concurrently, many physicians often use it in combination with one of the interferons or Copaxone. |
Additional information about interferons: Some individuals develop neutralizing antibodies (NABs) to the interferons (Avonex, Betaseron, and Rebif), but their impact on the effectiveness of these medications has not been established. Many continue to do well on these drugs despite the presence of NABs. Others may have sub-optimal results even without NABs present.
The MS Council and the American Academy of Neurology have concluded that the higher-dosed interferons are likely to be more effective than lower-dosed interferons. Several factors, however, must be considered when selecting one of these drugs, and this decision must be made on an individual basis under the guidance of a qualified physician.
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