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Cladribine in aggressive forms of multiple sclerosis
J E Martinez-Rodriguez1, D Cadavid, L J Wolansky
1Department of Neurology and Neurosciences, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07107-3001, USA.
European Journal of Neurology
|June 2, 2007
Summary
Cladribine treatment showed positive outcomes in six patients with aggressive relapsing multiple sclerosis (MS) who previously responded poorly to other therapies. This immunosuppressant drug reduced relapses and disability, with no serious adverse events observed.
Area of Science:
- Neuroimmunology
- Pharmacology
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Cladribine, an immunosuppressant, has shown variable efficacy in MS treatment.
- Aggressive relapsing MS poses significant challenges due to rapid progression and disability.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of cladribine in patients with aggressive relapsing MS.
- To assess the impact of cladribine on disease activity, disability progression, and relapse rates.
Main Methods:
- Retrospective evaluation of six patients with aggressive relapsing MS.
- Patients received cladribine at 0.07 mg/kg/day for five consecutive days monthly, with 2- to 4-monthly courses.
- Clinical outcomes (Expanded Disability Status Scale - EDSS, relapse rate) and MRI findings (gadolinium-enhancing lesions) were assessed.
Main Results:
- Significant reduction in mean EDSS from 6.42 to 3.75 after 6 months.
- Decrease or suppression of gadolinium-enhancing lesions on MRI scans.
- Mean relapse rate decreased from 2.67 per year to 0.71 per year during follow-up (mean 49.33 months).
- Four patients received a repeat cladribine course due to relapse recurrence, with similar positive results.
- No unexpected or serious adverse events were reported.
Conclusions:
- Cladribine demonstrated favorable clinical evolution in patients with aggressive relapsing MS unresponsive to other treatments.
- The drug effectively reduced disease activity and disability progression.
- Cladribine appears to be a safe and effective therapeutic option for this challenging MS subtype.
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