I was recently asked this provocative question and my answer is…. both yes and no! In the video I review my opinion that there are certain circumstances when Copaxone is our goto drug. There are many situation, however, when I would NOT want to use this product.
Importantly I’m talking about when I am helping choose a DMT for a person with MS in 2018. Not talking about switching a super responder to any of the given DMTs. I’m not suggesting someone who is doing well stop and switch. I
I am, however, sharing my personal opinion that in 2018, if I”m picking a new drug, I’m unlikely to reach for copaxone. If I could predict that someone would be a super responder to a given DMT I’d want to use that. But given that I can’t predict that ahead of time, and given that breakthrough disease has significant down stream consequences, I would rather start with a higher efficacy drug.
There are several situations where I feel Copaxone IS the best option:
1. A person who values safety of DMT over other factors may be the right fit for this very safe therapy.
2. This drug is a polypeptide (building block of protein). It doesn’t interact with other therapies, nor get processed by kidney or liver. As such it’s a goto drug when someone with MS has a co-morbid condition such as MS and cancer, MS and immunodeficiency, MS and liver transplant, etc.
3. Copaxone is increasingly being considered, albeit off label, during attempts at conception. This must be sorted out with a given woman with MS and her MS provider, but it’s a place we see it used more and more.
4. Lastly, Copaxone may have a role as a person transitions between two high efficacy DMTs during a needed washout period.
5. Lastly, as my friend Chris LaGanke says, “every drug has knocked it out of the park at least once!” If someone is responding most awesomely to a given DMT, I would not want to change that!
Please leave your comments and questions below. What do YOU think?
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