I don't know how big the CIS market is. I'm guessing >$1B but one point is that Copaxone is not alone here; Interferon beta-1a was shown by the CHAMPS trial (for Avonex) and ETOMS trial (for Rebif) to delay the onset of CDMS in patients with CIS, when compared with placebo. The BENEFIT trial demonstrated the efficacy of Betaseron in reducing conversion from CIS to CDMS and to McDonald MS (ie, using MRI-based criteria). Another point is that indeed docs already understand that decisions on therapy should be made as soon as possible perhaps at first demyelinating event when the patient had not had a second relapse but I think compliance rates can be low and discontinuations common in CIS patients.
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