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CLIPPERS Responsive to Cladribine as a Durable Steroid-Sparing Agent
Simon Thebault1, Hailey Bergman2, Harold L Atkins2
1From The Ottawa Hospital and University of Ottawa (S.T., H.B., H.L.A., M.S.F., J.B.), ON; and Perelman School of Medicine and University of Pennsylvania (S.T.), PA. thesdx@gmail.com.
Neurology(R) Neuroimmunology & Neuroinflammation
|November 17, 2022
Summary
This case study shows that cladribine, a steroid-sparing therapy, can induce durable remission in patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS). The patient achieved a steroid-free remission, indicating cladribine
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a rare neurologic condition.
- Diagnosis is often one of exclusion, with patients typically responding to corticosteroids.
Observation:
- A 25-year-old man with CLIPPERS experienced relapses upon attempting to wean steroid therapy.
- Significant side effects from long-term steroid use prompted consideration of alternative treatments.
Findings:
- Intravenous cladribine was administered as a steroid-sparing agent.
- The patient achieved durable clinical and MRI remission, enabling complete cessation of steroid therapy.
- Treatment was well-tolerated with only transient fatigue reported.
Implications:
- Intravenous cladribine represents a viable steroid-sparing therapeutic option for CLIPPERS.
- This approach may offer long-lasting disease control with a favorable safety profile in autoimmune neurologic conditions.
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