Life with MS & EDS

January 6, 2009

Decision Time

Tomorrow is my neurology appointment and it’s time to pick a medication. I’ve done the evaluation of the 4 Multiple Sclerosis drugs I was given the choice of: Avonex, Betaseron, Copaxone, and Rebif. I’ve check out their websites, watched their promotional DVDs, read their packets, and surfed around online to see what others had to say.

Before I continue, you should know I’m a project manager by trade. To be more specific, I’m an IT Portfolio Management Specialist. For most of my career I’ve done things such as evaluate projects, set scoring criteria, and provide data to senior leadership for decision-making. So, I’m trained to do research, create a scoring model, and assess alternatives against the criteria. What better way to think through this decision that to do the same thing here.

I have an old version of a decision-support tool which I used to create a model with four criteria and then compared their importance against one another. Here’s how it turned out:

Priority Graph

Priority Graph

Some of the text cut off. The first two are “Can tolerate short-term side effects” and “Can accept long-term side-effect risks.” In case you can’t see the graphics, the last two are “Number of shots” and “Ease of doing the injections.”  Drug efficacy was not considered because they all seem relatively equally effective in studies and therefore that wouldn’t differentiate the drugs in any meaningful way.

A bit too anal-retentive of me? Then I rated each drug against the criteria and here’s what I came up with:

Alternatives Graph

Alternatives Graph

There’s a lot of data behind this chart, but obviously Copaxone is way out in front. If you’ve been reading the other posts, you probably already figured out that I was leaning towards Copaxone. It really comes down to the side effects. While Copaxone obviously scored lowest in number of shots (daily injections), which I thought would be my main consideration before doing the research, it turns out that was the least of my concerns. Quality of life turns out to be much more important. The last thing I want to deal with is flu-like symptoms (even if they do subside after a period of time) or depression and I certainly don’t want to worry about the risk of long-term side effect like liver disease or thyroid issues, both of which already run in my family. So that rules out all of the Interferons (Avonex, Betaseron, and Rebif) and the only one left standing is Copaxone.

I’m looking forward to seeing what the neuro has to say tomorrow. Wish me luck! If you see this before mid-morning tomorrow and have suggestions for questions I should ask him, please let me know.

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