Wynn Daniel R
Director, Clinical Research; Consultants in Neurology, Multiple Sclerosis Center, Northbrook, IL, USA.
Mult Scler Int. 2019 Jan 15;2019:7151685. doi: 10.1155/2019/7151685. eCollection 2019.
Multiple sclerosis (MS) is a chronic progressive neurodegenerative demyelinating disease affecting the central nervous system. Glatiramer acetate (GA; Copaxone®) was the first disease-modifying treatment (DMT) for MS successfully tested in humans (1977) and was approved by the US Food and Drug Administration in December 1996. Since then, there have been numerous developments in the MS field: advances in neuroimaging allowing more rapid and accurate diagnosis; the availability of a range of DMTs including immunosuppressant monoclonal antibodies and oral agents; a more holistic approach to treatment by multidisciplinary teams; and an improved awareness of the need to consider a patient's preferences and patient-reported outcomes such as quality of life. The use of GA has endured throughout these advances. The purpose of this article is to provide an overview of the important developments in the MS field during the 20 years since GA was approved and to review clinical data for GA in MS, with the aim of understanding the continued and widespread use of GA. Both drug-related (efficacy versus side-effect profile and monitoring requirements) and patient factors (preferences regarding mode of administration and possible pregnancy) will be explored.
多发性硬化症（MS）是一种影响中枢神经系统的慢性进行性神经退行性脱髓鞘疾病。醋酸格拉替雷（GA；考帕松®）是第一种在人体中成功进行测试（1977年）的用于MS的疾病修正治疗药物（DMT），并于1996年12月获得美国食品药品监督管理局批准。从那时起，MS领域有了许多进展：神经影像学的进步使得诊断更加快速和准确；一系列DMT药物可供使用，包括免疫抑制单克隆抗体和口服药物；多学科团队采用更全面的治疗方法；以及人们更加意识到需要考虑患者的偏好和患者报告的结果，如生活质量。在这些进展过程中，GA一直在使用。本文的目的是概述自GA获批以来20年间MS领域的重要进展，并回顾GA在MS中的临床数据，旨在了解GA持续广泛使用的原因。将探讨与药物相关的因素（疗效与副作用特征以及监测要求）和患者因素（对给药方式的偏好以及可能的妊娠情况）。
