Coroner recommends further investigation into side effects of MS drug after death of woman

A coroner has recommended that the Health Products Regulatory Authority (HPRA) continues its investigations into the side effects of Glatiramer Acetate (GA), sold under the brand name Copaxone, a drug commonly used in the management of multiple sclerosis (MS).

The recommendation follows the death of Elaine Quinn, a 40-year-old mother of two, who suffered an anaphylactic shock in her home at Ross, Castlebar, Co Mayo, on February 12th, 2022, and died three days later in Mayo University Hospital (MUH).

After returning an open verdict at an inquest in Swinford on Monday, Pat O’Connor, the Coroner for the District of Mayo, said the HPRA should continue its investigations into the drug and inform the public and medical profession of its findings.

The medical cause of Ms Quinn’s death was acute fatal cerebral ischemia and anaphylactic shock.

Geraldine Maloney, Consultant Anaesthetist at MUH, gave evidence that Ms Quinn was admitted on February 9th, 2022 to intensive care following an out of hospital cardiac arrest.

Over the course of the day, she began taking antiviral, antibiotic, antiepileptic and steroid medication but three days later she died.

Dr Donal Tighe, a consultant gastroenterologist and general physician at MUH, said that information from Elaine’s family indicated that shortly after taking Copaxone for her multiple sclerosis she collapsed and an ambulance was called.

Dr Tighe said that in light of the fact that Ms Quinn collapsed shortly after receiving the drug it was possible it was the cause of the anaphylactic shock.

He said that on reviewing the medical literature there were some rare case reports of anaphylactic reactions to GA on patients who had been well established on the treatment.

“I couldn’t find any case reports of any fatalities associated with such anaphylactic reactions.

“It is possible that this [injection of GA] triggered an anaphylactic reaction that led to a catastrophic anoxic brain injury that Mrs Quinn unfortunately did not recover from.”

In correspondence to the coroner read into evidence at the hearing, consultant neurologist Dr Michael J Hennessy said GA has been commonly used in the management of multiple sclerosis for more than 20 years.

“Overall it would be regarded as an extremely safe form of MS immunomodulatory treatment,” he said.

“Therefore it is surprising and shocking to hear that it may have triggered anaphylaxis in this patient.”

Dr Hennessy said the association between the patient’s collapse and the injection is certainly suggestive of a causative effect.

“I can certainly find no prior examples of anaphylaxis causing death in a patient on this form of treatment,” he said.

At the conclusion of the inquest, having returned an open verdict, Coroner O’Connor said there are lessons to be learned from the death of the young mother.