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How does Copaxone work as treatment for multiple sclerosis?

Medically reviewed by Carmen Fookes, BPharm. Last updated on May 19, 2020.

Official Answer

by Drugs.com
  • Copaxone modifies immune processes that are thought to be responsible for the development of multiple sclerosis (MS).
  • Copaxone contains glatiramer acetate, which is a combination of the acetate salts of four naturally occurring amino acids: L-glutamic acid, L-alanine, L-tyrosine, and L-lysine.
  • These amino acids resemble the myelin protein surrounding nerve fibers and are thought to act as a decoy to divert an immune attack away from your myelin.
  • Copaxone has shown to significantly reduce the number of relapses in people with MS. 34 to 56% were relapse-free after two years.

Copaxone (glatiramer acetate) is a combination of four amino acids that may be used to treat relapsing forms of multiple sclerosis (MS) in adults, such as clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

How does Copaxone work in the body?

Experts aren’t sure exactly how Copaxone works in MS but it is thought to modify immune processes that are believed to be responsible for the development of MS.

Research has shown that after administration of glatiramer, glatiramer-specific suppressor T-cells are induced and activated in the peripheral nervous system. Although glatiramer is thought to modify the immune system response to MS, it does not appear to modify naturally occurring immune responses, although this has not been systematically evaluated.

Glatiramer acetate is a combination of the acetate salts of four naturally occurring amino acids: L-glutamic acid, L-alanine, L-tyrosine, and L-lysine. These amino acids resemble the myelin protein surrounding nerve fibers and are thought to act as a decoy to divert an immune attack away from your myelin.

Copaxone reduces the frequency of relapses, and some studies have reported a delay in the progression of the disease.

How long does it take Copaxone to work?

Copaxone starts working from the first injection; however, its effects may not be obvious for several months. Most people report it takes six to nine months before an effect is noticed. In some people, it may take longer.

Copaxone is considered a long-term treatment for MS and it has been available for the treatment of MS for more than ten years. Copaxone has been shown to significantly reduce the number of relapses in people with MS.

How effective if Copaxone?

Copaxone significantly reduces the number of relapses in people with MS. The results from two separate trials have reported:

  • 34 to 56% of people taking Copaxone were relapse-free after two years
  • For those that did relapse, an average of 0.6 to 1.2 relapses in 2 years was reported, compared with 1.7 to 2.4 relapses in 2 years in those who took a placebo
  • It took an average of 287 to 700 days before people had their first relapse while taking Copaxone, compared to 150 to 198 days in those taking placebo
  • 78 to 80% showed no disease progression compared to only 52 to 75% administered placebo.

Another trial reported that people administered Copaxone for one year had a 45% lower risk of brain lesions that showed inflamed areas in their brain and a 35% lower risk of new or growing brain lesions that showed damaged areas of the brain.

Because each individual course of MS is different, sometimes it can be difficult to determine how effectively a drug is working. For example, even though some people report an increase in lesions with Copaxone treatment, it may be that Copaxone has still decreased the number of lesions they would have developed had they not been taking anything.

How is Copaxone administered?

Copaxone is administered by subcutaneous injection (under the skin) into the arms, abdomen, hips, or thighs.

There are two recognized strengths of Copaxone, 20mg/ml and 40mg/ml, and the following specific dosing schedules correspond to each one:

  • Copaxone 20mg/mL, administered once daily, every day
  • Copaxone 40mg/ml, administered three times per week (at least 48 hours between dosages).
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