Review of oral MS treatments in clinical trials
Submitted by hollie on Wed, 2007-12-26 07:47.
This article (free access, at least for now) summarizes the current status of five oral drugs currently in clinical trial for MS: teriflunomide, laquinomod, fingolimod, BG00012, and cladribine. Results of completed trials are briefly described, and modes of action for each drug are discussed. The authors also talk about the problems with injected drugs and why people have a hard time adhering to them, but if you're all too familiar with those topics, just skip down to the section entitled, "What are the emerging options for oral therapy in MS?"
Hmmm. Is the driving factor
Hmmm. Is the driving factor to produce oral therapies to grow market share among non-compliant needlephobes, or is it to address the underlying MS?
My gut feel is that these therapies will turn out to be clinically inferior (in terms of efficacy AND side effects) to the currently available injected drugs. But yes Virginia, they will be oral drugs.
I would imagine that most MS patients would be best served if they didn't really care HOW the drug gets into them, if it really helps their disease. An engagement with a good therapist to desensitize issues around self injection would be far preferable to adopting an inferior treatment protocol for their MS.
There are issues with
There are issues with injecting other than needle-phobia. Site reactions is a major one. Lipoatrophy in particular can be very nasty (big gaping holes in your body where the fat just atrophies away). Personally, I'm sick of big bruises all over my abdomen.
Also, injections have to deliver the entire drug payload in one go, whereas sustained release formulations of oral drugs can spread it out over time.
As to efficacy, we haven't gotten any phase 3 data yet, but at least the phase 2 on FTY720 looks about as good as any of the injectables. Typically, oral drugs work differently than injectables, so there is the hope of synergistic effect by taking 2 drugs. I'd rather have at least one be oral if I'm going to do that.
This is not to say that pharma shouldn't be working on ways to do neuroprotection and repair.
***
Art Mellor, Accelerated Cure Project for MS, art-msnews -at- acceleratedcure.com