title: A pilot trial of Cop 1 in exacerbating-remitting multiple sclerosis.
abstract: Cop 1 is a random polymer (molecular weight, 14,000 to 23,000) simulating myelin basic protein. It is synthesized by polymerizing L-alanine, L-glutamic acid, L-lysine, and L-tyrosine. It suppresses but does not induce experimental allergic encephalomyelitis, an animal model of multiple sclerosis. It is not toxic in animals. In a double-blind, randomized, placebo-controlled pilot trial, we studied 50 patients with the exacerbating-remitting form of multiple sclerosis, who self-injected either 20 mg of Cop 1 dissolved in 1 ml of saline or saline alone daily for two years. Six of 23 patients in the placebo group (26 percent) and 14 of 25 patients in the Cop 1 group (56 percent) had no exacerbations (P = 0.045). There were 62 exacerbations in the placebo group and 16 in the Cop 1 group, yielding two-year averages of 2.7 and 0.6 per patient, respectively. Among patients who were less disabled on entry (Kurtzke disability score, 0 to 2), there were 2.7 exacerbations in the placebo group and 0.3 in the Cop 1 group over two years. Among patients who were more affected (Kurtzke disability score, 3 to 6), there was an average of 2.7 exacerbations in the placebo group and 1.0 in the Cop 1 group. Over two years, less disabled patients taking Cop 1 improved an average of 0.5 Kurtzke units; those taking placebo worsened an average of 1.2 Kurtzke units. More disabled patients worsened by 0.3 (Cop 1 group) and 0.4 (placebo group) unit. Irritation at injection sites and rare, transient vasomotor responses were observed as side effects. These results suggest that Cop 1 may be beneficial in patients with the exacerbating-remitting form of multiple sclerosis, but we emphasize that the study is a preliminary one and our data require confirmation by a more extensive clinical trial.
authors.forename: M B
authors.initials: MB
authors.lastname: Bornstein
authors.forename: A
authors.initials: A
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Slagle
authors.forename: M
authors.initials: M
authors.lastname: Weitzman
authors.forename: H
authors.initials: H
authors.lastname: Crystal
authors.forename: E
authors.initials: E
authors.lastname: Drexler
authors.forename: M
authors.initials: M
authors.lastname: Keilson
authors.forename: A
authors.initials: A
authors.lastname: Merriam
authors.forename: S
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: V
authors.initials: V
authors.lastname: Spada
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011897:Random Allocation
chemical_list: D010455:Peptides; C021759:(T,G)-A-L