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Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review
Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by inflammation and demyelination for which there is currently no cure; therefore, the aim of therapy is to reduce the risk of relapse and disability progression. The treatment options for MS have increased greatly in recen...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Healthcare
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940595/ https://www.ncbi.nlm.nih.gov/pubmed/35318617 http://dx.doi.org/10.1007/s40120-022-00339-7 |
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author | Giovannoni, Gavin Mathews, Joela |
author_facet | Giovannoni, Gavin Mathews, Joela |
author_sort | Giovannoni, Gavin |
collection | PubMed |
description | Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by inflammation and demyelination for which there is currently no cure; therefore, the aim of therapy is to reduce the risk of relapse and disability progression. The treatment options for MS have increased greatly in recent years with the development of several disease-modifying therapies (DMTs) and the advent of immune reconstitution therapy (IRT). IRTs are administered in short-dosing periods to produce long-term effects on the immune system. Treatment with an IRT is based on the 3Rs: reduction, repopulation, and reconstitution of lymphocytes, which leads to restoration of immune effector functions. Cladribine tablets represent a selective, high-efficacy, oral form of IRT for patients with MS that targets lymphocytes and spares innate immune cells. Patients require only two weekly treatment courses, with each course comprising two treatment weeks, in Years 1 and 2; therefore, cladribine tablets are associated with a lower monitoring burden than many other DMTs, while short dosing periods can help to improve adherence. This review provides an overview of IRT and offers the clinician’s perspective on the current MS treatment landscape, with a focus on practical advice for the management of patients undergoing treatment with cladribine tablets based on the most recent evidence available, including risks associated with COVID-19 and recommendations for vaccination in patients with MS. |
format | Online Article Text |
id | pubmed-8940595 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-89405952022-03-23 Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review Giovannoni, Gavin Mathews, Joela Neurol Ther Review Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by inflammation and demyelination for which there is currently no cure; therefore, the aim of therapy is to reduce the risk of relapse and disability progression. The treatment options for MS have increased greatly in recent years with the development of several disease-modifying therapies (DMTs) and the advent of immune reconstitution therapy (IRT). IRTs are administered in short-dosing periods to produce long-term effects on the immune system. Treatment with an IRT is based on the 3Rs: reduction, repopulation, and reconstitution of lymphocytes, which leads to restoration of immune effector functions. Cladribine tablets represent a selective, high-efficacy, oral form of IRT for patients with MS that targets lymphocytes and spares innate immune cells. Patients require only two weekly treatment courses, with each course comprising two treatment weeks, in Years 1 and 2; therefore, cladribine tablets are associated with a lower monitoring burden than many other DMTs, while short dosing periods can help to improve adherence. This review provides an overview of IRT and offers the clinician’s perspective on the current MS treatment landscape, with a focus on practical advice for the management of patients undergoing treatment with cladribine tablets based on the most recent evidence available, including risks associated with COVID-19 and recommendations for vaccination in patients with MS. Springer Healthcare 2022-03-23 /pmc/articles/PMC8940595/ /pubmed/35318617 http://dx.doi.org/10.1007/s40120-022-00339-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Review Giovannoni, Gavin Mathews, Joela Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title | Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title_full | Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title_fullStr | Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title_full_unstemmed | Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title_short | Cladribine Tablets for Relapsing–Remitting Multiple Sclerosis: A Clinician’s Review |
title_sort | cladribine tablets for relapsing–remitting multiple sclerosis: a clinician’s review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940595/ https://www.ncbi.nlm.nih.gov/pubmed/35318617 http://dx.doi.org/10.1007/s40120-022-00339-7 |
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