Jun 15, 2009
First oral MS drug one of many treatment advances on horizon
The first oral medication for MS, expected to hit the market early next year, could herald a new era in treatment that offers more choice, convenience, effectiveness and economy, researchers say.
With 75 new drugs in the research pipeline, MS is the most rapidly advancing disease for drug research in the country.
On the horizon are:
- Five oral medications
- Generics or “biosimilars” of currently available self-injected drugs
- Monoclonal antibodies, highly targeted drugs that require less frequent dosing
- Drugs that are currently available for other conditions but have yet to be approved for MS
“There’s a ton of excitement,” says Dr. Mariko Kita, a neurologist and MS specialist at Virginia Mason Medical Center in Seattle. But that excitement is tempered with lots of questions and unknowns.
Patients in consultation with their doctors will have to weigh whether it’s in their best interest to switch from one of the six FDA-approved drugs currently available to something new.
“Patients who are very stable on a medication may choose to stick with what they have,” she says. Others will have to decide which drug is the best fit for the severity of their disease, taking into account their overall health and how comfortable they are with risk.
The first of the oral drugs expected to hit the market is Cladribine, a version of a chemotherapy drug that is so potent most patients would take it for 10 days in the first two weeks and be set for the rest of the year.
After that, comes Fingolimod (or FTY720), an immunosuppressant that prevents certain immune cells from migrating to the brain and spinal cord and causing damage. Following Fingolimod are three oral drugs that act as anti-inflammatories: BG00012 or
BG-12, Laquinimod and Teriflunomide.
All of the oral drugs appear to be well tolerated despite their potency, but will require careful monitoring, says Dr. Kita, who is involved in the clinical trials on Fingolimod and BG-12.
Knowing there will soon be an effective oral medication available for his MS brings peace of mind to Jeff Shannon, who is taking part in the Fingolimod trials. A self-injected treatment really wasn’t an option for him because of the amount of traveling he does on business.
“An oral medication means freedom,” he says. “When I heard about this drug trial, I was thrilled to be able to do something for future generations and myself.”