Glatiramer acetate is a synthetic compound made of four amino acids (the building blocks of proteins) that are found in myelin. It has been shown in clinical trials that glatiramer acetate reduces the number and severity of relapses and appears to slow the onset of disability in some people with MS. While the mode of action of glatiramer acetate is not completely understood, it is different from that of the interferons.
Over the past 15 years, there have been many clinical trials to investigate the efficacy and safety of glatiramer acetate in people with MS. The best results were seen in people with MS who had the lowest levels of neurological disability. Studies have shown that at the end of 2 years there were about 25% fewer relapses in people taking glatiramer acetate compared with those not taking the drug, and more people on the drug tended to improve.

Administering glatiramer acetate

The drug is injected subcutaneously (under the skin) every day. People with MS or family members who first receive proper training in aseptic injection techniques can perform the injections without medical supervision.

Side effects of the drug

The drug is generally well tolerated and does not cause any of the ‘flu-like symptoms or increase in depression sometimes associated with the interferon drugs. The most common side effects are injection site reactions, pain upon injection, and a postinjection reaction involving shortness of breath, flushing, palpitations, anxiety and chest pain. This reaction, which occurs in about one in seven people at one time or another resolves itself within 15–20 minutes and does not appear to have any long-term consequences. At the time it can, however, be very frightening.

Prescribing glatiramer acetate (Copaxone)

As the effect of glatiramer acetate and its process of development have been broadly similar to that of the interferons, it has also been subject to the same process of assessment by NICE as the interferons (see above). The same judgement was also made in relation to glatiramer acetate, as were also the same risk-sharing arrangements with the company manufacturing the drug. Thus the drug is also available for prescription by neurologists in MS clinics using slightly different criteria. To be prescribed the drug, people must fulfil the following criteria:

• be able to walk at least 100 metres without assistance
• have had at least two clinically significant relapses in the last 2 years
• be 18 years old or older.