MS Drug Therapies – “What the Future Holds”
Over the last few years, the MS market has been driven by five disease-modifying agents: Teva’s Copaxone (glatiramer acetate), Biogen Idec’s Avonex (interferon beta-1a) and Tysabri (natalizumab), Merck KGaA’s Rebif (interferon beta-1a) and Bayer’s Betaferon (interferon beta-1b). From 2009, interferon beta-1b has also been available from Novartis as Extavia; this is the same formulation as Betaferon.
In addition to these, Amgen’s Novantrone (mitoxantrone) has been available to treat MS. Generic mitoxantrone is also available. Avonex, Betaferon/Extavia, Rebif and Copaxone are all used in first-line therapy for RRMS. They are generally well accepted and have accumulated comprehensive safety and clinical trial data supporting their use in modifying the course of the disease. Tysabri and mitoxantrone are generally used in second-line therapy in RRMS. Mitoxantrone is also approved to treat SPMS and PRMS. Both of these agents are associated with serious side-effects.
The arrival of oral treatments brings big clinical advantages:
The development of oral therapies for MS has attracted significant investment from pharmaceutical companies and the first of these have begun to receive marketing approvals, signalling another major change in the way MS is treated. In September 2010, Novartis won the race to gain the first oral approval in the US with its sphingosine-1-phosphate (S1P) receptor agonist, Gilenya. The product was also approved in Russia in the same month. Merck’s oral product, Movectro (cladribine) was approved in Russia in July 2010 and in Australia in September 2010 for the treatment of RRMS for a maximum duration of two years. However, the European Medicine Agency’s CHMP issued a negative opinion for Movectro for the treatment of RRMS.
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