Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, (5), CD004678

Glatiramer Acetate for Multiple Sclerosis

Affiliations
Review

Glatiramer Acetate for Multiple Sclerosis

Loredana La Mantia et al. Cochrane Database Syst Rev.

Abstract

Background: This is an updated Cochrane review of the previous version published (Cochrane Database of Systematic Reviews 2004 , Issue 1 . Art. No.: CD004678. DOI: 10.1002/14651858.CD004678)Previous studies have shown that glatiramer acetate (Copaxone (R)), a synthetic amino acid polymer is effective in experimental allergic encephalomyelitis (EAE), and improve the outcome of patients with multiple sclerosis (MS).

Objectives: To verify the clinical efficacy of glatiramer acetate in the treatment of MS patients with relapsing remitting (RR) and progressive (P) course.

Search strategy: We searched the Cochrane MS Group Trials Register (26 March 2009), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2009), MEDLINE (PubMed) (January 1966 to 26 March 2009), EMBASE (January 1988 to 26 March 2009) and hand searching of symposia reports (1990-2009).

Selection criteria: All randomised controlled trials (RCTs) comparing glatiramer acetate and placebo in patients with definite MS, whatever the administration schedule and disease course, were eligible for this review.

Data collection and analysis: Both patients with RR and P MS were analysed. Study protocols were comparable across trials. No major flaws were found in methodological quality. However, efficacy of blinding should be balanced against side effects, including injection-site reactions.

Main results: Among 409 retrieved references, we identified 16 RCTs; six of them, published between 1987 and 2007, met the selection criteria and were included in this review. Five hundred and forty RR patients and 1049 PMS contributed to the analysis. In RR MS, a decrease in the mean EDSS score (-0.33 and -0.45), was found respectively at 2 years and 35 months without any significant effect on sustained disease progression. The reduction of mean number of relapse was evident at 1 year (-0.35 ) 2 years (-0.51 ) and 35 months (-0.64), but significant studies ' heterogeneity was found. The number of hospitalisations and steroid courses were significantly reduced. No benefit was shown in P MS patients. No major toxicity was found. The most common systemic adverse event was a transient and self-limiting patterned reaction of flushing, chest tightness, sweating, palpitations, anxiety. Local injection-site reactions were observed in up to a half of patients treated with glatiramer acetate, thus making a blind assessment of outcomes questionable.

Authors' conclusions: Glatiramer acetate did show a partial efficacy in RR MS in term of relapse -related clinical outcomes, without any significant effect on clinical progression of disease measured as sustained disability. The drug is not effective in progressive MS patients.

Update of

  • Therapy With Glatiramer Acetate for Multiple Sclerosis
    L Munari et al. Cochrane Database Syst Rev (1), CD004678. PMID 14974077. - Review
    Glatiramer acetate did not show any beneficial effect on the main outcome measures in MS, i.e. disease progression, and it does not substantially affect the risk of clini …

Similar articles

  • Therapy With Glatiramer Acetate for Multiple Sclerosis
    L Munari et al. Cochrane Database Syst Rev (1), CD004678. PMID 14974077. - Review
    Glatiramer acetate did not show any beneficial effect on the main outcome measures in MS, i.e. disease progression, and it does not substantially affect the risk of clini …
  • Immunomodulators and Immunosuppressants for Multiple Sclerosis: A Network Meta-Analysis
    G Filippini et al. Cochrane Database Syst Rev (6), CD008933. PMID 23744561. - Review
    Our review should provide some guidance to clinicians and patients. On the basis of high quality evidence, natalizumab and IFNß-1a (Rebif) are superior to all other treat …
  • Teriflunomide for Multiple Sclerosis
    D He et al. Cochrane Database Syst Rev 3, CD009882. PMID 27003123. - Review
    There was low-quality evidence to support that teriflunomide at a dose of 7 mg/day or 14 mg/day as monotherapy reduces both the number of participants with at least one r …
  • Interferons-beta Versus Glatiramer Acetate for Relapsing-Remitting Multiple Sclerosis
    L La Mantia et al. Cochrane Database Syst Rev 11 (11), CD009333. PMID 27880972. - Review
    The effects of IFNs-beta and GA in the treatment of people with RRMS, including clinical (e.g. people with relapse, risk to progression) and MRI (Gd-enhancing lesions) me …
  • Teriflunomide for Multiple Sclerosis
    D He et al. Cochrane Database Syst Rev 12, CD009882. PMID 23235682. - Review
    We found low-level evidence for the use of teriflunomide as a disease-modifying therapy for MS, due to the limited quality of the available RCTs. We did not conduct meta- …
See all similar articles

Cited by 28 PubMed Central articles

See all "Cited by" articles

MeSH terms

LinkOut - more resources

Feedback