Enduring Clinical Value of Copaxone® (Glatiramer Acetate) in Multiple Sclerosis after 20 Years of Use

<div>Timeline of approval by the FDA of disease-modifying therapies for multiple sclerosis. FDA: Food and Drug Administration; IM: intramuscular; SC: subcutaneous. <svg height="10.1334pt" id="M1" style="vertical-align:-0.2455101pt" version="1.1" viewbox="-0.0498162 -9.88789 58.9687 10.1334" width="58.9687pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z"></path></g><g transform="matrix(.013,0,0,-0.013,4.599,0)"><path d="M303 0V28C221 34 213 39 213 125V525C213 610 221 616 303 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265C396 269 400 277 400 297C400 374 333 449 250 449H249C198 449 144 421 103 376S37 269 37 201C37 88 109 -12 232 -12C263 -12 332 6 395 84L380 106ZM225 412C281 412 315 364 314 312C314 297 308 292 290 292C232 290 176 289 120 289C135 370 180 412 225 412Z"></path></g><g transform="matrix(.013,0,0,-0.013,40.43,0)"><path d="M181 342V451C133 431 89 419 40 411V388C98 381 102 377 102 311V104C102 38 95 32 33 26V0H263V26C186 32 181 38 181 104V287C203 343 235 372 261 372C277 372 289 366 304 352C310 346 318 345 330 350C349 359 362 379 362 399C362 422 338 449 304 449C256 449 213 393 183 342H181Z"></path></g><g transform="matrix(.013,0,0,-0.013,45.083,0)"><path d="M257 449C165 449 37 374 37 209C37 98 119 -12 256 -12C355 -12 473 65 473 226C473 349 381 449 257 449ZM244 416C333 416 380 320 380 204C380 67 329 21 267 21C184 21 130 115 130 241C130 354 184 416 244 416Z"></path></g><g transform="matrix(.013,0,0,-0.013,51.556,0)"><path d="M524 0V26C466 32 460 36 460 104V297C460 393 411 449 331 449C302 449 276 437 248 419C223 402 201 387 181 372V451C137 432 90 420 42 411V388C96 378 102 374 102 310V104C102 38 97 33 29 26V0H246V26C187 32 181 36 181 104V339C211 365 250 390 290 390C357 390 381 345 381 276V109C381 40 374 32 315 26V0H524Z"></path></g></svg> beta-1b was also approved in 2009 as Extavia® (which is the Novartis-branded version of the Bayer product Betaseron®). <svg height="12.4033pt" id="M2" style="vertical-align:-0.2456007pt" version="1.1" viewbox="-0.0498162 -12.1577 45.4189 12.4033" width="45.4189pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M156 406V710C117 695 54 682 9 675V647C73 642 75 635 75 573V25C131 -2 180 -12 223 -12C359 -12 478 92 478 240C478 357 387 451 278 451C265 451 251 447 236 440L156 406ZM156 373C175 384 208 392 235 392C315 392 387 328 387 214C387 97 332 30 251 31C197 31 170 66 162 84C158 93 156 104 156 118V373Z"></path></g><g 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Glatopa™ [<a href="/journals/msi/2019/7151685/#B8">10</a>] was approved in 2015 by the FDA. Other generic versions were approved in the EU in 2016 and by the FDA in 2017 [<a href="/journals/msi/2019/7151685/#B9">11</a>, <a href="/journals/msi/2019/7151685/#B10">12</a>]. <svg height="13.0172pt" id="M3" style="vertical-align:-3.129311pt" version="1.1" viewbox="-0.0498162 -9.88789 76.6641 13.0172" width="76.6641pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.0091,0,0,-0.0091,0,-5.741)"><path d="M396 114C349 71 317 59 274 59C216 59 123 104 123 241C123 342 180 400 246 400C283 400 317 386 348 359C355 352 361 348 366 348C378 348 401 371 402 394C402 405 398 413 385 424C369 437 337 451 294 451H293C254 451 193 434 141 394C73 342 39 277 39 198C39 90 114 -12 243 -12C303 -12 371 31 415 90L396 114Z"></path></g><g transform="matrix(.013,0,0,-0.013,4.444,0)"><path d="M372 352C427 368 507 407 507 502C507 548 486 592 451 616C420 638 376 650 301 650H44V622C124 616 128 610 128 527V123C128 40 122 34 36 28V0H257C336 0 402 12 453 40C512 72 548 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Multiple Sclerosis International

fig1

Figure 1

Figure 1: Enduring Clinical Value of Copaxone® (Glatiramer Acetate) in Multiple Sclerosis after 20 Years of Use 