How to choose between the orals??

[lorib]

Saw my neuro today and he wants me to consider switching my DMD. Here's my brief MS history -

Diagnosed Jan. 2004 started Betaseron. On Beta for approx. 5 years with two relapses. The last relapse was because I built up antibodies. Started Tysabri for 1 year. Switched to Copaxone because neuro was worried about PML and I wanted to have another baby. Recently found out I'm JCV +. Have been on Copaxone for 8 months. I haven't had any relapses since 2009, but there was an active lesion with my last MRI in August 2012. Technically this can be considered a relapse, but I had no symptoms. I had been off Copaxone for about a year because I had a baby so I doubt the Copaxone wasn't working for me, rather it was the fact I was on nothing.

Fast forward to now and my neuro talked about Copaxone 3 times a week, Aubagio, or Tecfidera. He doesn't seem to prefer any of the three so it's up to me. I don't like the shots but I've been doing them for 8 years so it's not that bad. But what's the difference between those two orals? They look about the same to me except Aubagio is cheaper (I think) and Tecfidera might have antioxidant like properties (neuro protective?).

My MS is basically invisible. My only symptoms are that I am constantly tired (and have been for 5 years) and left arm/hand tingling. And my left hand has lost it's ability to perform fine motor movements. Any thoughts will be appreciated!

[JerryD]

Hi lorib,
I wish the drug companies had a solution for me. I am PPMS. There's no treatment, FDA approved, for me.
I would try Tecfidera because it has somewhat of a track record, as it is, substantially, BG-12 or Fumaderm, which has been used in Europe for several years. And it is based on 'fumaric acid esters' which is a compound that is largely organically based. So good luck in your journey.

[Myoak]

Here are trial results of Tecfidera and Aubagio. All involved comparison to placebo. Since each trial had a different patient population results are not directly comparable but until both drugs are compared in a single trial it is the best we can do.

It appears Tecfidera has better numbers for effectiveness. The unknown is which one your body would tolerate best. That could make a big difference, obviously. Both drugs have a track record; Tecfidera is very similar to fumaderm which has been used for years and Aubagio is very similar to leflunomide which has been used in RA.

Last year Aubagio was priced at $45k and this year Tecfidera was priced at $54k per year. Gilenya, the other oral drug for MS is about $60k per year.

If your choice is between Tecfidera and Aubagio I rec that you Google both and read the prescribing info. Here are trial results:

Tecfidera Define Trial Results Taken twice daily (BID)

53% annual reduction in relapse rate
44% relapse rate reduction at 24 months
21% reduction in disease progression
38% reduction in disability progression
85% reduction in the mean number of new or newly enlarging T2 hyperintense lesions
90% reduction in gadolinium enhancing lesions
72% reduction in T1 hypointense lesions

Tecfidera Confirm Trial Results Taken twice daily (BID)

44% annual reduction in relapse rate
34% relapse rate reduction at 24 months
21% reduction in disability progression
71% reduction in the mean number of new
or newly enlarging T2 hyperintense lesions
74% reduction in gadolinium enhancing lesions
57% reduction in T1 hypointense lesions
30% reduction in brain atrophy


Aubagio TEMSO Trial 14MG

31% reduction in annualized relapse rate
30% reduction in disability progression
76% reduction in new T2 hyperintense lesions
80% reduction in gadolinium enhancing lesions
31% reduction in T1 hypointense lesions
67% reduction in total lesion volume


Aubagio TOWER Trial 14MG

36% reduction in annualized relapse rate
31% reduction in disability rate

[Look2theStars]

Here are trial results of Tecfidera and Aubagio. All involved comparison to placebo. Since each trial had a different patient population results are not directly comparable but until both drugs are compared in a single trial it is the best we can do.

It appears Tecfidera has better numbers for effectiveness. The unknown is which one your body would tolerate best. That could make a big difference, obviously. Both drugs have a track record; Tecfidera is very similar to fumaderm which has been used for years and Aubagio is very similar to leflunomide which has been used in RA.

Last year Aubagio was priced at $45k and this year Tecfidera was priced at $54k per year. Gilenya, the other oral drug for MS is about $60k per year.

If your choice is between Tecfidera and Aubagio I rec that you Google both and read the prescribing info. Here are trial results:

Tecfidera Define Trial Results Taken twice daily (BID)

53% annual reduction in relapse rate
44% relapse rate reduction at 24 months
21% reduction in disease progression
38% reduction in disability progression
85% reduction in the mean number of new or newly enlarging T2 hyperintense lesions
90% reduction in gadolinium enhancing lesions
72% reduction in T1 hypointense lesions

Tecfidera Confirm Trial Results Taken twice daily (BID)

44% annual reduction in relapse rate
34% relapse rate reduction at 24 months
21% reduction in disability progression
71% reduction in the mean number of new
or newly enlarging T2 hyperintense lesions
74% reduction in gadolinium enhancing lesions
57% reduction in T1 hypointense lesions
30% reduction in brain atrophy


Aubagio TEMSO Trial 14MG

31% reduction in annualized relapse rate
30% reduction in disability progression
76% reduction in new T2 hyperintense lesions
80% reduction in gadolinium enhancing lesions
31% reduction in T1 hypointense lesions
67% reduction in total lesion volume


Aubagio TOWER Trial 14MG

36% reduction in annualized relapse rate
31% reduction in disability rate

Tecifedera is the answer here. My Neuro also confirmed better results are happening with Tecifedera than Aubagio..

[lorib]

I thought about it last night and I'm going to switch to Tecfidera. I'm getting another month of Copaxone tomorrow...so hopefully I'll start the new drug by July!

[JamCakes]

Thank God For Choices and People Who Create Them

Thank you for this info, I am also making this decision right now! I have done well with the Rebif, but it is becoming increasingly difficult for me to give myself the shots. I have hard, painful knots on my thighs and butt from 8 years of 3-shots a week. I can't do stomach (WAY too painful), and won't do arms, so I am now down to two small upper-butt spots where I inject. Not good!

Also, I believe that the new drugs like Tecfidera will do a better job of delaying disability, and keeping my brain whole.

I am choosing Tecfidera (BG-12). Hopefully, my choice will be approved by my doctor and even more importantly - approved by my insurance company.

[allHailye2]

@JamCakes

i'm gonna talk to my neuro (tomorrow actually) about switching from rebif to tecfidera. i've been on the 'bif for 13 years. (lol at 'bif)

i know the knots hurt. i have some myself. i've been shooting up my sides and hips also. (lack of sites) try that until u get to switch to something else