my neuro says avonex is meant to be a stopper

[newidme]

and not a 'repairer', that avonex does not reverse damages. He said rebif and avonex are 2 diofferent medicines that aim to achieve the same goal. Forgive me if this is elementary 4 any of ya, but I am still in the phase whre I am trying to make freakin sense of all of this.

[Jules A]

That is my understanding also. The medications hopefully will prevent progression. It is a lot to learn during a very stressful time. Hang in there.

[sportsfan]

Rebif and Avonex are different meds but I believe they have the same chemical makeup (interferon beta-1a) the difference being the dosage and how they are administered. It's very overwhelming when you are first dxed, read a lot and ask lots of questions it will help. MSWorld is a great resource.

[0485c10]

The MS meds slow MS, your body is the one that heals MS as much as it as able. So there is a ware going on inside your body, with MS trying to demylenate your nervs and your body trying to repair the damage. The MS meds just give a handicap to the MS giving your body an edge in the competition.

MS is called multiple scars for a reason. You body is putting scars on the demylenated nerves just as if you had a cut on your hand. You could see the scars, with MS the scares can only bee sen on the MRI. And just like the scars on your hand the scar can form so well its almpst invisible, its an ugly mass and somtimes it doesn't heal at all.

The MS meds just slow the MS down so your body has a chance to heal it any where from 1-99%. It never heals to a 100% there will always be some weakness(noticed most at higher temps & fatigue) in the tissue from the lesion that was there and at 0% its no longer RR but its SP. So your body will heal it anywhere from 1-99%.

MS meds slow MS and there is a reason you want to slow it, so your body has the greatest advantage in the competition going on inside your body.

Both Avonnex and Rebif are interferon-1a, the same substance. But every Rebif shot, done 3x a week contains more interferon-1a than the single avonnex shot done once a week.

Often when avonex becomes less effective in a person, the doc will switch that person to Rebif.

But they both have the same effectiveness of about 30%. Its just more in Rebif.

As I hacve read many posts of people being switched from Avonnex to Rebif when they needed something stronger, so too I have read of one person who had anaphalaxis shock after using copaxone-turns out she had a history of reactions to meds, so her doc switched her to Avonnex which used less of the med and only 1x per week instead of a 3x a week risk of anaphalaxis shock.

The amount of med needed may be less and lower frequency for about the same effect because its delivery as an intra muscular shot instead of subcutaneous shot. And more frequent subcutaneous delivery may need more and may keep a higher and more consistent level in the body?? Its just theories of why the effectiveness is similar and one requires more??? But people tend to go from Avonnex to Rebif and not the other way.

[0485c10]

MS meds don't stop relapses they just make the ones that happen less frequent and less severe when they happen. My first MS med was betaseron and it shipped with the results of the trial that had been used to get it approved by the FDA. Plecebo has 2 relapses a year and on betsearon had 1 relapse every 2 years---about 30%. Same effectiveness in all the CRAB drugs--Copaxone,Rebi,Avonex,Betasiron.

[Sir-Voor]

MS meds don't stop relapses they just make the ones that happen less frequent and less severe when they happen. My first MS med was betaseron and it shipped with the results of the trial that had been used to get it approved by the FDA. Plecebo has 2 relapses a year and on betsearon had 1 relapse every 2 years---about 30%. Same effectiveness in all the CRAB drugs--Copaxone,Rebi,Avonex,Betasiron.

Agree! The CRAB drugs just slow progression, hopefully to a near stop.
Each one is different for each person, what work great for one person does not for the next person.
On average some have a higher percentage of slowing then others, but as we all know all to well every case of MS is different and treatments work is also different.

MY understanding there is two kinds of damage with MS, lesions in the brain and nerve leakage via holes in the myelin out side the brain.

Ampyra is the only on the market come close to repairing, by plugging leaks in the myelin outside of the brain.

I think the CRABs work by doing a targeted suppression of the immune system, with each having a little different target range and strength of suppression.
And the bad immune cells is a little different in us all, so when one drug is on target the other just misses the bad cells.

[0485c10]

Agree! The CRAB drugs just slow progression, hopefully to a near stop.
Each one is different for each person, what work great for one person does not for the next person.
On average some have a higher percentage of slowing then others, but as we all know all to well every case of MS is different and treatments work is also different.

MY understanding there is two kinds of damage with MS, lesions in the brain and nerve leakage via holes in the myelin out side the brain.

Ampyra is the only on the market come close to repairing, by plugging leaks in the myelin outside of the brain.

Someone wrote, who had a milder case of MS, that her doc had advised her to start a med, despite mild symptoms because it was possible to slow her MS down to near stalling it with the meds. I liked that description of what is possible. It can't stop it or cure it but its possible it can be slowed down to the point of stalling it

Like you said everyone's response is different & some may get a drug that nearly stalls it---and some find they have to switch to another when it is found, that one isn't effective enough for them. And the only way a person finds that out is by trial.(there might be some tests in the future that will predict a persons response to a med before they use it---but thats still in research for distant future, not in the present. Presently its trial and error to find the right one for a person).

I'm not on Ampyra, but my understanding of how Ampyra works it improves the speed of nerve conduction between nerves. A nerve impulse has to travel through many nerve axons to get an action, and the nerve to nerve conduction speed Ampya, improves that in some with Ampyra.

Ampyra support the potassium part of the sodium-potassium ion pump(Na-K) of the action potential in the Node of Ranvier between the axons of nerves.

Wikki
definition of Node of Ranvier...

http://en.wikipedia.org/wiki/Nodes_of_Ranvier

nerve Action potential in the Node of Renvier Na-K ion pump.

http://en.wikipedia.org/wiki/Action_potential

[BigA]

Avonex and Rebif are the same medecine. Rebif is considered stronger due to larger, more frequent dose.

If you're worried, start with the larger dose. You'll never be wondering and you can change later.

[baconbits]

MY understanding there is two kinds of damage with MS, lesions in the brain and nerve leakage via holes in the myelin out side the brain.

I think the CRABs work by doing a targeted suppression of the immune system, with each having a little different target range and strength of suppression.
And the bad immune cells is a little different in us all, so when one drug is on target the other just misses the bad cells.

This isn't accurate. The CRAB drugs are immunomodulators, not immune suppressors. All of them work outside the blood brain barrier (BBB) to modify the immune cells crossing the BBB. In untreated MS, when these cells cross, they may attack myelin or cause inflammation. In someone taking a CRAB drug, the modified cells start producing antiinflammatory proteins and nerve growth factor instead, helping to decrease MS damage. The interferons (all CRABs but Copaxone) also work to heal the holes in the BBB so that fewer damaging cells can cross.

Immune suppressors are drugs like tysabri and the two orals that are being considered (fingolimod and cladribine). They actually selectively decrease the strength of your immune system.

As far as the types of damage from MS, I have no idea what "nerve leakage" means, but it's certainly not something I've ever heard in connection with MS.

[newidme]

thank u

c10, your post helped me to understand. ans yours, too, sir v.


thanks. *sigh* Iam saddened by all of this. But the stem cell thing gives me awesome hope. thanks to everyone who has read/replied.

[0485c10]

Avonex and Rebif are the same medecine. Rebif is considered stronger due to larger, more frequent dose.

If you're worried, start with the larger dose. You'll never be wondering and you can change later.

BigA makes a point if you have no issues where once a week delivery is better for you.

The crab drugs first came out in 1993 thru 1996. It was the first time there were any treatments for MS. Before that there was no treatment for MS only treatment for the symptoms. The all had about 30% effectiveness.

In 2004 the second generation of MS med started coming out with greater effectiveness 60% but more risk too. We are getting to know them and work is being done to reduce the risk. And oral drugs are about 40-50% and there is even one IV delivery in last stage of trials, designated as a fast track drug review by the FDA that is all the way up to 80% effective.
Every new drug is more effective than the current Crab drugs but carry more risk..

Because the new drugs all carry more risk than the 30% crab drugs, the fda often designates them as 2nd line treatment eligible. For use after one of the 1st line treatments(30% crab drugs) has been used.

Its not such a bad idea to start with what is thought to be the strongest of the 1st line drugs so your next drug will be one of these more effective 2nd line drugs---and you don't waste any more time in the 30% 1st line drugs.

What Sir-Voor wrote is so important to understanding the politics of a DMD(disease modifying drug) the effectiveness is different in each person & everyone is tremendously loyal to the one they have chosen. So to say rebif is "stronger" to someone who is using avonex and responding well to Avonnex, is like a slap in the face and has resulted in message board arguments!. Personally my first DMD was betaseron & I think it is better than Rebif, there are those that say copaxone is better than any of the the others....Its really a very political post about DMD selection.

I did want to point out to you the financial programs that Avonnex and Rebif both have for co pays. Its the same substance by the same company offering financial assistance. Where copays are not allowed to go above a certain amount in the first year-regardless of income.

http://www.needymeds.org/drug_list.t...me&name=Avonex

http://www.needymeds.org/drug_list.t...ame&name=Rebif

[0485c10]

My apology, the first 2 oral drugs should be out next year and they have equal or greater effeciency than anything currently on the market at 60+ efficiency not in between the 30% crap drugs and the 60% Tysabri...but the orals are at 60% or better when they com out---but they do have a greater risk than the crab drugs.

[BigA]

BigA makes a point if you have no issues where once a week delivery is better for you.

The crab drugs first came out in 1993 thru 1996. It was the first time there were any treatments for MS. Before that there was no treatment for MS only treatment for the symptoms. The all had about 30% effectiveness.

In 2004 the second generation of MS med started coming out with greater effectiveness 60% but more risk too. We are getting to know them and work is being done to reduce the risk. And oral drugs are about 40-50% and there is even one IV delivery in last stage of trials, designated as a fast track drug review by the FDA that is all the way up to 80% effective.
Every new drug is more effective than the current Crab drugs but carry more risk..

Because the new drugs all carry more risk than the 30% crab drugs, the fda often designates them as 2nd line treatment eligible. For use after one of the 1st line treatments(30% crab drugs) has been used.

Its not such a bad idea to start with what is thought to be the strongest of the 1st line drugs so your next drug will be one of these more effective 2nd line drugs---and you don't waste any more time in the 30% 1st line drugs.

What Sir-Voor wrote is so important to understanding the politics of a DMD(disease modifying drug) the effectiveness is different in each person & everyone is tremendously loyal to the one they have chosen. So to say rebif is "stronger" to someone who is using avonex and responding well to Avonnex, is like a slap in the face and has resulted in message board arguments!. Personally my first DMD was betaseron & I think it is better than Rebif, there are those that say copaxone is better than any of the the others....Its really a very political post about DMD selection.

I did want to point out to you the financial programs that Avonnex and Rebif both have for co pays. Its the same substance by the same company offering financial assistance. Where copays are not allowed to go above a certain amount in the first year-regardless of income.

http://www.needymeds.org/drug_list.t...me&name=Avonex

http://www.needymeds.org/drug_list.t...ame&name=Rebif

Thanks for calling it what it is: Politics. I will add science, religion, marketing and luck too.

[newidme]

BigA makes a point if you have no issues where once a week delivery is better for you.

The CRAB drugs first came out in 1993 thru 1996. It was the first time there were any treatments for MS. Before that there was no treatment for MS only treatment for the symptoms. The all had about 30% effectiveness.

In 2004 the second generation of MS med started coming out with greater effectiveness 60% but more risk too. We are getting to know them and work is being done to reduce the risk. And oral drugs are about 40-50% and there is even one IV delivery in last stage of trials, designated as a fast track drug review by the FDA that is all the way up to 80% effective.
Every new drug is more effective than the current Crab drugs but carry more risk..

Because the new drugs all carry more risk than the 30% crab drugs, the fda often designates them as 2nd line treatment eligible. For use after one of the 1st line treatments(30% crab drugs) has been used.

Its not such a bad idea to start with what is thought to be the strongest of the 1st line drugs so your next drug will be one of these more effective 2nd line drugs---and you don't waste any more time in the 30% 1st line drugs.

What Sir-Voor wrote is so important to understanding the politics of a DMD(disease modifying drug) the effectiveness is different in each person & everyone is tremendously loyal to the one they have chosen. So to say rebif is "stronger" to someone who is using avonex and responding well to Avonex, is like a slap in the face and has resulted in message board arguments!. Personally my first DMD was betaseron & I think it is better than Rebif, there are those that say copaxone is better than any of the the others....Its really a very political post about DMD selection.

I did want to point out to you the financial programs that Avonex and Rebif both have for co pays. Its the same substance by the same company offering financial assistance. Where copays are not allowed to go above a certain amount in the first year-regardless of income.

http://www.needymeds.org/drug_list.t...me&name=Avonex

http://www.needymeds.org/drug_list.t...ame&name=Rebif

Good post. thank you. This community is gentle. thx