glatirameracetat

Glatiramer acetate, marketed under brand names such as Copaxone, is a disease-modifying therapy used to treat relapsing forms of multiple sclerosis. It is a synthetic, random polymer composed of four amino acids—glutamic acid, alanine, tyrosine, and lysine—formulated as a sterile subcutaneous injection.

Mechanism of action: The exact mechanism is not fully understood. It is thought to modulate the immune system by acting as a decoy for myelin-reactive T cells and by shifting the immune response from a pro-inflammatory Th1 profile toward an anti-inflammatory Th2 profile, potentially promoting regulatory T-cell activity. This may reduce demyelinating attacks.

Indications and use: It is indicated to reduce relapse rate in relapsing forms of multiple sclerosis and is not considered a cure. It is generally not used for primary progressive MS.

Administration: It is administered by subcutaneous injection, with dosing varying by product (historically 20 mg daily or 40 mg three times weekly). Patients rotate injection sites to minimize irritation. Benefits typically accrue over months, and it does not provide immediate relief from symptoms.

Efficacy: In clinical trials, glatiramer acetate reduced the annualized relapse rate and decreased new MRI lesions compared with placebo, with reductions commonly reported in the range of about 25–30%.

Adverse effects: Common adverse effects include injection-site reactions and lipoatrophy. Some patients may experience transient systemic reactions after injection, such as flushing, chest tightness, or palpitations, which usually resolve within minutes. Rare hypersensitivity or systemic reactions can occur.

Pregnancy and safety: Glatiramer acetate is generally considered relatively safe in pregnancy when clinically indicated, though data are limited and decisions should involve a clinician.

Availability: Brand names include Copaxone; generic versions and other formulations exist in various regions.