Table 1

Injectable DMTs

TreatmentDose/administrationFDA approvalCommon side effects
Interferon β-1a
Avonex
30 µg intramuscular weeklyDecrease disability and reduces frequency of clinical exacerbations by 32% in RRMS at 2 years
Approved 1996
Pregnancy category C
Headache, influenza-like symptoms, depression
Mild decrease in WCC and elevation in LFTs although rare
Interferon β-1b
Betaseron
0.25 mg SC every other dayTo reduce frequency of clinical exacerbations by 31% in RRMS at 2 years
Approved 1993
Pregnancy category C
Headache, influenza-like symptoms, depression
Injection site reactions
Mild decrease in WCC and elevation in LFTs
Interferon β-1b
Extavia
0.25 mg SC every other dayTo reduce frequency of clinical exacerbations by 34% in RRMS
Approved 2009
Pregnancy category C
Headache, influenza-like symptoms, depression
Injection site reactions
Mild decrease in WCC and elevation in LFTs
Interferon β-1a
Rebif
22 µg or 44 µg SC 3xweeklyTo reduce frequency of clinical exacerbations by 33% in RRMS at 2 years
Approved 2002
Pregnancy category C
Headache, influenza-like symptoms, depression
Injection site reactions
Mild decrease in WCC and elevation in LFTs with one fatal case reported
Pegylated interferon β-1a
Plegridy
125mcg SC once in 14 daysTo reduce frequency of clinical exacerbations by 35.6% in RRMS
Approved 2014
Pregnancy category C
Headache, influenza-like symptoms, depression
Injection site reactions
Mild decrease in WCC and elevation in LFTs
Glatiramer acetate
Copaxone
20 mg SC once daily or 40 mg SC three times weeklyTo reduce frequency of clinical exacerbations by 29% in RRMS at 2 years
Approved 1997
3 times weekly 2014
Pregnancy category B
Injection site reactions are usually mild
10% with one time palpitations, chest pain, and SOB
Injection site reactions including lipoatrophy
Glatiramer acetate
Glatopa
20 mg SC once dailyTo reduce frequency of clinical exacerbations by 30% in RRMS
Approved 2015
Pregnancy category B
Approximately 10% of patients may experience transient symptoms after an injection such as palpitations, chest pain, diaphoresis, and shortness of breath
Daclizumab
Zinbryta
150 mg SC once every 28 daysTo reduce frequency of clinical exacerbations by 45% in RRMS
As a second-line or third-line therapy
Approved 2016
Pregnancy category None
Colds, URI, rash, eczema, skin hypersensitivity reactions, subcutaneous infections and infestations, depression, lymphadenopathy, colitis, and acute hepatitis
Elevation of LFTs, some cases being severe
  • DMT, disease-modifying therapy; FDA, Food and Drug Administration; LFTs, liver function tests; RRMS, relapsing-remitting multiple sclerosis; SC, subcutaneous; SOB, shortness of breath; URI, upper respiratory infections; WCC, white cell count.