First-line treatment with Copaxone (glatiramer acetate) benefits relapsing-remitting multiple sclerosis (RRMS) patients by boosting the number of anti-inflammatory immune cells and restoring the balance of regulatory immune cells, an Italian study shows.
The study, “Biological activity of glatiramer acetate on Treg and anti-inflammatory monocytes persists for more than 10 years in responder multiple sclerosis patients,” appeared in the journal Clinical Immunology.
Multiple sclerosis (MS) is an autoimmune disorder in which the body’s own immune cells attack host cells and tissues. MS patients often have fewer regulatory immune cells, which control autoimmune responses.
Copaxone, marketed by Israel’s Teva Pharmaceuticals, is one of the most common therapies prescribed for RRMS. Although it is not fully clear how the drug works, it can modulate immune responses while protecting the neurological system.
Previous studies have shown that Copaxone induces production of anti-inflammatory mediators and regulates the levels of some subgroups of immune cells. But these are considered short-term effects of the therapy, and little is known about its long-term effects.
To better understand Copaxone action in MS, Italian researchers at Turin’s Neuroscience Institute Cavalieri Ottolenghi investigated the long-term effects in the immune system subpopulations of RRMS patients treated with this drug.
The researchers analyzed blood samples from 37 healthy volunteers (with no acute or chronic diseases) and 90 RRMS patients. The latter samples were collected at several time points of Copaxone treatment – before treatment, from 10 to 15 months of therapy, and from 34 to 192 months of therapy.
Only 19 percent of patients receiving long-term Copaxone therapy (34 to 192 months) relapsed within the first two years of treatment, the study found, while 29 percent relapsed during the entire duration of the treatment. In addition, 32 percent did not show neurological progression detected by magnetic resonance imaging (MRI), or progression of EDSS (Expanded Disability Status Scale) score or clinical relapse.
Detailed analysis of autoimmunity-related immune cell subpopulations showed that their numbers didn’t change after long-term Copaxone treatment. Along with the positive clinical response observed for this group of patients, the authors hypothesized that Copaxone therapy changes the way these immune cells function rather than alter their numbers.
Copaxone was also found to increase the percentage of anti-inflammatory immune cells during the first year, as well as in long-term treatment. In addition, the treatment re-established the number and function of regulatory immune cells in this group of patients.
“In conclusion, we show that daily administration of [Copaxone] causes a continuous stimulus which induces an increase of [regulatory immune cells], that in turn suppress the autoimmune response typical of MS.” the researchers wrote. “We demonstrate that these changes are stable for the whole period of the treatment as highlighted by the data obtained from patients treated for more than 100 months.”