Long-term management of multiple sclerosis patients treated with cladribine tablets: an expert opinion. 2020

Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
Abteilung für Neurologie, Universitätsklinikum Münster , Münster, Germany.

BACKGROUND Oral cladribine is a highly effective pulsed selective immune reconstitution therapy licensed for relapsing multiple sclerosis. A full treatment course comprises two treatment cycles given with 1 year of intermission. Further dosing is not routinely recommended in years 3 and 4. METHODS The long-term management of patients treated with oral cladribine has not been fully defined on the basis of clinical studies as of yet. The authors provide their expert opinion on this. CONCLUSIONS Based on available evidence and experience from routine clinical use, the authors suggest a structured approach to the long-term management of patients treated with cladribine tablets according to their responder type, i. e. the degree and timing of disease activity, if any, after treatment initiation. Informed treatment decisions require structured patient monitoring by established clinical and imaging parameters. In patients with relevant disease activity in year 3 or 4 and beyond, the use of additional cycle(s) of oral cladribine might become an option. For patients requiring a treatment switch, the choice of therapies primarily includes moderately to highly effective MS drugs.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D009103 Multiple Sclerosis An autoimmune disorder mainly affecting young adults and characterized by destruction of myelin in the central nervous system. Pathologic findings include multiple sharply demarcated areas of demyelination throughout the white matter of the central nervous system. Clinical manifestations include visual loss, extra-ocular movement disorders, paresthesias, loss of sensation, weakness, dysarthria, spasticity, ataxia, and bladder dysfunction. The usual pattern is one of recurrent attacks followed by partial recovery (see MULTIPLE SCLEROSIS, RELAPSING-REMITTING), but acute fulminating and chronic progressive forms (see MULTIPLE SCLEROSIS, CHRONIC PROGRESSIVE) also occur. (Adams et al., Principles of Neurology, 6th ed, p903) MS (Multiple Sclerosis),Multiple Sclerosis, Acute Fulminating,Sclerosis, Disseminated,Disseminated Sclerosis,Sclerosis, Multiple
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005104 Expert Testimony Presentation of pertinent data by one with special skill or knowledge representing mastery of a particular subject. Expert Opinion,Expert Witness,Expert Opinions,Expert Testimonies,Expert Witnesses,Opinion, Expert,Testimony, Expert,Witness, Expert,Witnesses, Expert
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D013607 Tablets Solid dosage forms, of varying weight, size, and shape, which may be molded or compressed, and which contain a medicinal substance in pure or diluted form. (Dorland, 28th ed) Tablet
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

Related Publications

Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
January 2023, Therapeutic advances in neurological disorders,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
June 2024, Neurology and therapy,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
January 2023, Multiple sclerosis and related disorders,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
January 2022, Current neuropharmacology,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
June 2021, Multiple sclerosis and related disorders,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
September 2021, Multiple sclerosis and related disorders,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
January 2023, Degenerative neurological and neuromuscular disease,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
May 2022, Multiple sclerosis and related disorders,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
July 2022, European journal of neurology,
Sven G Meuth, and Antonios Bayas, and Boris Kallmann, and Christoph Kleinschnitz, and Ralf Linker, and Peter Rieckmann, and Mathias Mäurer
October 2023, Neurology and therapy,
Copied contents to your clipboard!