Evening everyone Been doing a bit of research on DMDS had all the tests just awaiting to go back to neuro, RRMS already been suggested by him just wanted LP to rule out something Question I see .some are told what DMD they will get and some are given a choice. Is there a reason for this ? He mentioned tablets are now available , presume he ment Gilenya Thanks Gray

Hi Gray, as far as I know it will vary depending on the hospital and PCT, but also if you do not take beta interferons you are sometimes then not eligible for oral drugs. Hopefully someone else will advise as I’m not 100% certain of that

I guess it is as rufus wrote.

I wasn’t offered Copaxone. I guess so that going on to 2nd line drugs is straight foward. I was offered a weekly injection (Avonex) (needing cold storage) or every other day injections (IFN beta-1b). No REBIF as I’m in Scotland and no bid was submitted to supply it to NHS Scotland. The IFN beta-1b turned out to be Exatavia which I read somewhere is to be expected in Scotland rather than Betaferon (Another contract matter?).

Re. tablets : Sunday, 1 September 2013, “EU grants marketing authorization for teriflunomide for RRMSers” a once-daily, tablet.

All I can add it that my neuro only offered me Copaxone as he thought that it was the DMD least likely to make my fatigue worse.


hi i was given the choice but after meeting nurse i decided to go on rebif.i live just outside glasgow and i had no problem getting rebif and bupa deliver everything to my door and nurse who specialises in rebif came to my house to go through injection process

Hi Gray,

You are supposed to have a choice of the firstline DMDs, as none is markedly more effective than any of the others, so there’s no clinical case for preferring one to another. The patient should be allowed to pick the one that is most compatible with their lifestyle and priorities.

Having said that, the interferons may be contra-indicated for patients with a history of depression, so those may be offered only Copaxone. There may be other pre-existing medical conditions that rule out some choices, or at least mean there would be a caution against them.

Patients whose MS is judged more aggressive from the start might be able to bypass the standard firstline drugs, and in that case, one of the more powerful but potentially riskier drugs may be proposed.

I thought Gilenya was usually available only to patients who had first tried interferons without success, but I suppose, if you have a supportive neuro, you may be able to get anything, if he makes the case for it.