Sunday, August 19, 2012

Which DMD is 4 ME?

DMD = Disease Modifying Drug
DMT = Disease Modifying Therapy


Copaxone, Rebif, Avonex, Betaseron/Extavia, Tysabri, Gilenya,  Novantrone!


These are all FDA approved DMD's for MS










Which is right for me?  How do they work?
 Copaxone



  •  daily Injection
  •  subcutaneous (little needle)
  •  can be used with auto injector
  •  synthetic protein (glatiramer acetate )
  •  daily injection
How it works -
This drug is believed to blocks T-cells which destroy myelin.

Common sides effects (that normally clear up )
injection site swelling - some get welts
fatigue
runny nose
weight gain

if any other side effects occur, consult your doctor
 List of additional Side Effects
REBIF interferon beta-1a


  •  injection
  •  3 times a week
  •  can be used with auto injector
  •  subcutaneous
  •  known as interferon beta-1a
  •  it made up of amino acids that are found naturally in the body specifically  interferon beta-1a
  •  titrate to full dose
HOW IT WORKS
Rebif is an interferon therapy. Interferons belong to a family of proteins that naturally occur in the body. Rebif contains specifically interferon beta-1a. This type of interferon is identical to the body's natural human interferon beta. The exact way Rebif works is not known.
Common side effects
flu-like symptoms - Since flu-like symptoms are a fairly common side effect during the initial weeks of treatment, it is recommended that the injection be given at bedtime. Taking acetaminophen (Tylenol®) or ibuprofen (Advil®) immediately prior to each injection and during the 24 hours following the injection will also help to relieve the flu-like symptoms.

If you experience any of the below - consult your doctor
depression
allergic reactions
liver function
seizures

 List of Rebif Side Effects

You should have blood test regularly to check your liver function and blood counts
AVONEX interferon beta 1a







  • injection
  • once a week
  • intermuscular
  • amino acid interferon beta 1a
  • often give as first medication to newly diagnosed
  • now has an autoinjector
  • titrate to full dose

HOW IT WORKS
it is believed that it stops the immune system from destoying Myelin

Common Side Effects
flu-like symptoms (fatigue, chills, fever, muscle aches, and sweating). Most of these symptoms will tend to disappear after the initial few weeks of treatment. If they continue, become more severe, or cause you significant discomfort, be sure to talk them over with your physician.
 
If you experience any of the below - consult your doctor
depression
allergic reactions
liver function
seizures
heart issues

Avonex Side Effects
You should have blood test regularly to check your liver function and blood counts
BETASERON/EXTAVIA -interferon beta 1b

 

  • injection
  • subcutaneous
  • every other day
  • made of amino acids
HOW IT WORKS
it is believed that it stops the immune system from destoying Myelin

Common Side Effects
flu-like symptoms (fatigue, chills, fever, muscle aches, and sweating). Most of these symptoms will tend to disappear after the initial few weeks of treatment. If they continue, become more severe, or cause you significant discomfort, be sure to talk them over with your physician.
If you experience any of the below - consult your doctor
depression
allergic reactions
liver function
seizures
heart issues

Betaseron/Extavia side effects


Gilenya (fingolimod)












  • First and ony Oral Medication
  • Daily pill

HOW IT WORKS
Lymphocytes are what attach disease in our immune system,  Since MS patients have a hperactive immune system, these Lymphocytes attack the Myelin,  Gilenya sequesters some of the the Lymphocytes in our Lymph Nodes.  How this actually works for MS is unknown
Common Side Effects
  • Headache
  • Flu
  • Diarrhea
  • Back pain
  • Abnormal liver tests
  • Cough


If you experience any of the below - consult your physician right away
  • vision problems
  • dizziness 
  • slow heartrate
  • infection


see Gilenya Side Effects


TYSABRI









  • IV infusion every 4 weeks (28 days)
  •  normally not given unless you are non-responsive to other therapies
  • antibody and not an interferon
HOW IT WORKS
- thought to keep white lood cells  from getting into the brain and attacking nerves which in turns is believed to result in fewer lesions

COMMON SIDE EFFECTS
  • Hives
  • Trouble breathing
  • Chest pain
  • Dizziness
  • Chills
  • Rash
  • Nausea
  • Flushing of skin
  • Low blood pressure
  • see more side effects
    Potential Serious Side Effects
    Liver Damage
    Serious infection
    PML - Progressive multifocal leukoencephalopathy


    NOVANTRONE (mitoxantrone)




    •  originally use to fight certain forms of cancer
    •  IV infusion every 3 months
    •  there is a lifetime maximum with this drug (8-12 doses over 2 years)
    HOW IT WORKS
     It acts in MS by suppressing the activity of T cells, B cells, and macrophages that are thought to lead the attack on the myelin sheath.
    SIDE EFFECTS
    As this is an agressive drug, that was designed for chemo there is a list of potential side effects, such as weakened immune system and cardiac issues.  See list of side effects by visiting the NMSS website  - click here SIDE EFFECTS


    WHAT IS RIGHT FOR ME???
    We all respond to medication differently. It is important to speak to your doctor about your options. Have your doctor educate you on the different medications and TOGETHER - decide what you will try. This choice should be made TOGETHER



    RESEARCH and go into doc well informed.
    No matter which you decide to go on, the important thing to remeber is always be on a DMD.  Until there is a cure, this is our opportunuity to try and reduce our relapses and disease progression.  The drugs listed above have all been approved by the FDA.  Be weary of presented "CURES" or quick fixes.  They sadly dont exist and often times its just a scheme to get your money and create false hope.

    Along with a Medication, you should eat healthy and remember to MOVE IT

    *** Information in this blog regarding each drug was borrowed from the National Multiple Sclerosis Society and each drugs Websites.

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