Table 2.
Established MS DMTs.
| ESTABLISHED MULTIPLE SCLEROSIS DISEASE-MODIFYING THERAPIES | |||||||
|---|---|---|---|---|---|---|---|
| INTERFERON BETA 1B | INTERFERON BETA 1A | GLATIRAMER ACETATE | NATALIZUMAB | FINGOLIMOD | |||
| Brand name | Betaseron/Betaferon (μg) | Extavia (μg) | Avonex (μg) | Rebif (μg) | Copaxone (mg) | Tysabri | Gilenya |
| Mechanism of action | Inhibits antigen presentation and promotes a shift from Th1 cells towards Th2 cells | Inhibits antigen presentation and promotes a shift from Th1 cells towards Th2 cells | Inhibits antigen presentation and promotes a shift from Th1 cells towards Th2 cells | Inhibits antigen presentation and promotes a shift from Th1 cells towards Th2 cells | Promotes a shift from Th1 cells towards Th2 cells | Selectively binds to α4 subunit of (VLA-4), preventing the interaction between VLA-4 and VCAM-1 | Antagonist of sphingosine- 1-phosphate receptor, interfering in the egress of lymphocytes from the lymph nodes |
| Year approved | 1993 | 2009 | 1996 | 2002 | 1997 | 2004, 2006 | 2010 |
| Dose | 250 | 250 | 30 | 22 or 44 | 20 | 300 mg | 0.5 mg |
| Route | SC | SC | IM | SC | SC | IV | Oral |
| Frequency | Every 48 h | Every 48 h | Weekly | Three times weekly | Daily | Every four weeks | Daily |
| Most relevant side effects | Flu-like symptoms*, hepatitis | Flu-like symptoms, hepatitis | Flu-like symptoms, hepatitis | Flu-like symptoms, hepatitis | Local skin reactions | High risk of pro- gressive multifocal leukoencephalopathy | High rates of herpesvirus infections and bradycardia at the first dose |
Notes:
*
Flu-like symptoms: fever, chills, myalgia, and articular pain.
Abbreviations: IV, intravenous; IM, intramuscular; SC, subcutaneous.