Copaxone shown to protect against neuronal injury in RRMS

Glatiramer acetate may improve metabolic recovery and offer protection from axonal injury, suggesting a potential neuroprotective effect, according to a recent paper in Multiple Sclerosis.The paper describes the results of a pilot study in 22 treatment-naive patients with relapsing-remitting multiple sclerosis. Eighteen patients were treated with glatiramer acetate (Copaxone; 20mg daily), and four patients chose to remain untreated and acted as controls. Changes in NAA/Cr ratio were measured with annual magnetic resonance imaging (MRI) and magnetic resonance spectroscopy imaging (MRSI). Relapse rates were also determined at six-monthly neurological assessments.Increases in NAA (n-acetylaspartate) levels in the brain may indicate reversal of axonal loss and have been shown to strongly correlate with improved clinical disability. After two years, NAA/Cr in the treated group increased significantly by 10.7% in the volume of interest (VOI) and by 7.1% in the normal appearing white matter (NAWM). The increases occurred predominantly during the first year of treatment and remained stable during the second year. In contrast, NAA/Cr in the untreated group decreased by 8.9% in the VOI and 8.2% in the NAWM over the two-year period. In addition, the relapse rate was reduced by 50% in the treated group but remained unchanged in the untreated group.Discussing the results, chief investigator Omar Khan said, "The increases in NAA/Cr ratios with Copaxone suggested sustained beneficial effects on cerebral axonal recovery. We believe this indicates a potential for improved electrical conduction pathways in the brain, supporting the emerging concept that, centrally, Copaxone may be acting as a neuroprotective agent."The study is planned to continue for at least four years to provide more insight into the anti-inflammatory and potential neuroprotective mechanisms of glatiramer acetate, the authors say. "We recognise our study contains limitations, such as the number of patients, open-label design, and the MRS technique of evaluating NAA levels," said Dr Khan. "However, our recently presented three-year data showed sustained improvements in NAA/Cr ratios which clearly demonstrated a long-term clinical benefits and showed that Copaxone treatment may lead to neuronal recovery." The three-year data was presented at the June 2005 European Neurological Society Meeting in Vienna. Reference...