AI Article Synopsis
- Oral cladribine is an effective treatment for relapsing multiple sclerosis, involving two treatment cycles with a one-year break in between, and is not typically recommended for use in years 3 and 4.
- Current long-term management strategies for patients receiving oral cladribine have not been fully established through clinical studies, prompting expert opinions in the field.
- Experts recommend a structured monitoring approach based on patients' responses and disease activity, suggesting that additional doses may be considered for those experiencing relevant activity in years 3 or 4, along with options for switching to other effective MS therapies.
Article Abstract
Introduction: 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.
Areas Covered: 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.
Expert Opinion: 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.
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| http://dx.doi.org/10.1080/14656566.2020.1792885 | DOI Listing |
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