Publications by authors named "Hashem Salloukh"
Cladribine tablets have been granted marketing authorization in Europe and approved by the Food and Drug Administration (FDA) in the USA to treat relapsing forms of multiple sclerosis (MS). However, people with MS (PwMS) may be more familiar, and therefore more confident, with treatments requiring long-term and frequent dosing. Differences in such treatment strategies can lead to questions relating to how short-course non-continuous treatments, such as cladribine tablets, can work and how well they are tolerated.
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- Cladribine tablets (CladT) are used as an immune therapy for relapsing multiple sclerosis (RMS) and involve treatment over two years, but some patients may still experience new disease activity (DA) after completing the regimen.
- A systematic literature review (SLR) was conducted to address key questions from multiple sclerosis experts about managing breakthrough DA and the long-term use of CladT, analyzing 35 publications of real-world evidence (RWE) from the last 15 years.
- Findings indicate that while breakthrough DA in the first year is relatively low, it can occur, especially in patients previously using specific other treatments, and some patients may experience DA later on, although treatment discontinuation is uncommon.
What Is This Summary About?: People with multiple sclerosis (shortened to MS) who are taking cladribine tablets may have concerns about whether they can be vaccinated against COVID-19. This summary details the findings from a previously published article, in which an international committee of 10 MS experts developed recommendations to answer some important questions about COVID-19 vaccines in people with MS (including relapsing-remitting or active secondary progressive disease) taking cladribine tablets.
What Were The Results?: The committee identified 13 recommendations, which were all agreed upon by at least three-quarters (75%) of the 38 voting MS experts.
Article Synopsis
- There are unresolved questions about using cladribine tablets for multiple sclerosis treatment during the COVID-19 pandemic, particularly concerning vaccination.
- An international group of MS experts developed consensus-based recommendations to clarify how cladribine treatment interacts with COVID-19 vaccination.
- The final recommendations cover vaccination necessity, timing relative to treatment, and safety, achieving consensus agreement from a broad panel of experts.
Article Synopsis
- Current product labels and clinical guidelines for cladribine tablets in treating relapsing multiple sclerosis (MS) are insufficient, prompting the need for expert recommendations.* -
- A steering committee of nine international MS experts developed 11 clinical questions, achieving consensus on 46 out of 47 recommendations regarding the practical use of cladribine tablets.* -
- The consensus includes guidance on various important topics like defining highly active disease, managing treatment responses, pregnancy planning, malignancy and infection risks, and switching medications.*
Recent data demonstrate the fundamental role of endothelin in the pathogenesis of fibrosis, and the anti-fibrotic potential of dual endothelin receptor antagonists such as bosentan. Although transforming growth factor-beta, aldosterone and connective tissue growth factor, have already been established as contributors to the process of fibrosis, endothelin now emerges as a key player, which may have a role both in the initiation and in maintenance of fibrosis, and may mediate the pro-fibrotic effects of the other agents. Bosentan is an orally active, dual endothelin receptor antagonist, which competitively antagonizes the binding of endothelin to both endothelin receptors ETA and ETB.
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