Decision Resources, a research firm in the pharmaceutical/healthcare industries surveyed neurologists about their anticipated use of the new oral MS medications (optimistically anticipated to be released to market in late 2009). These medications (cladribine and fingolimod) promise better treatment responses with no injections.
However, in the survey, neurologists thought that the oral medications would make up less than 30% of the "first line" treatment in multiple sclerosis. Most neurologist expect to keep to the current treatments expect to continue to use the current treatments.
The treatments most likely to lose market share to the oral medications are other "first line" treatments like Avonex, Betaseron and Copaxone. Tysabri is thought to be more immune to "market loss" because it is currently only used after the other "first line" treatments fail.
Around 38.8% of newly diagnosed patients receive any treatment in their first year after diagnosis - these patients (and their neurologists) may be more likely to begin treatment soon if the treatment is oral (and without many side effects, which I am in the process of researching on the oral drugs).
Read more about the survey.
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I am currently taking part in the Fingolimod clinical trial & would hope that Neurologists would keep an open mind to prescribing this drug for patients. I was diagnosed only 6mths ago, and was not going to take any of the injectable medications, not only because I didn’t want to have an injection each day but because I didn’t want any of the side affects that could come along with it. If my health was fine I didn’t want this injection to be a painful reminder that I had MS. These new drugs could turn out to be a “Godsend” for many. They are like taking your daily vitamins, no painful shots and no reaction sites. They have been shown to have very few if any side affects, and may even end up being even better at preventing new lesions from forming then the injectables.
As any other new medicine, the real side effects show up only “in the wild” – so I will happily stay with my side effects for some years and weait for relevant results – say for three years , minimum. Remember Lipobay ?
The Fingolimod trial has been taking place for several years. It has had to go through a few phases, and this phase III trial that I am now enrolled in has a length of 2 years, and it has just had it’s first set of patients to end the trial which means they started it 2 years ago when it first opened. I do not expect people that are on medications that working well for them to jump on the “oral medication bandwagon”, however these new meds will open up a world of treatment possibilities to many people out there that otherwise would not be treating this disease, as well as people that have not been satisified by the current drug options out there.
This is the same with any medicine hitting the market – they had to go thru phase III and so on, thats the same in Europe (Where I am from). Anyway, there are often/mostly (?)undiscovered side effects and not too few pills that had to be withdrawn: Example: I personally like Grape juice and have hayfever – means I had to learn that the medicine I took for about 10 years could have killed me when used as prescribed – this was Terfenadin (name as sold in Germany).
The problem is that no type of test, study, etc. can reveal everything. But I agree that this is also a matter of personal risk to take. Me, I rather want to reach the age of my Grandma (95), so means I can take the Avonex stuff and side effects a bit longer ans wait what the usage of the new drugs reveal.
Addition to the aforesaid I just read about side effects known of Fingolimod: At least two people died in June 2008, one developed a Herpes-entephalitis, the other varicella. (source german wikipedia)