Experience with the use of cladribine tablets in real-life clinical practice: independent analysis of data from 12 Russian clinical centres DOI Creative Commons
Alexey Boyко, В. М. Алифирова, D. V. Pashkovskaya

и другие.

Neurology neuropsychiatry Psychosomatics, Год журнала: 2024, Номер 16, С. 44 - 50

Опубликована: Авг. 7, 2024

Multiple sclerosis (MS) is an autoimmune-inflammatory and neurodegenerative disease of the central nervous system. The article analyses ability cladribine, which due to its selective lymphotoxic effect on activated cells immunomodulation in brain tissue underwent successful clinical trials 2010, when it was (temporarily) approved Russia. Objective: analyse cladribine tablets daily practice course MS over 3–4 year observational period after immune reconstitution therapy (IRT) several neurological clinics from different regions Material methods . We collected data 235 patients 12 regional centres who were followed for average 3.4 years starting treatment. Results. An independent analysis cases prescribed showed that reason prescribing highly active (HARS) 159 (67.7%) patients, rapidly progressive (RPMS) 20 (8.5%), relapsing-remitting – 50 (21.3%) secondary with exacerbations 6 (2.5%). Only (5.1%) these had not previously received disease-modifying therapies (DMTs), i.e. drug first DMT prescribed. Among a second-line DMTs before switching 22 natalizumab, 5 ocrelizumab only 1 fingolimod. Remaining (n=195) switched first-line DMTs. In all cases, decrease frequency observed during completion IRT course. Exacerbations between second 36 (15.3% treated patients), including almost half those natalizumab (17 or 47.2% exacerbations, developed therapy) three (8.3 % therapy, 60 cladribine). After full treatment four-year observation period, occurred 14 (6% included analysis), six natalizumab. Conclusion. results are generally consistent recently published meta-analyses reviews, but high likelihood such as noteworthy. Both drugs aggressive types (highly progressive) increase Expanded Disability Status Scale (EDSS) scores prior being drugs. switch usually increased risk developing multifocal encephalopathy titre antibodies against JC-virus duration natal izumab use more than 2 years. It likely resumption activity discontinuation quite pronounced, replacement tablet form able completely prevent this. this respect, does appear be optimal, contrast where cladribine.

Язык: Английский

Cost-effectiveness of the Floodlight® MS app in Austria. Unlocking the mystery of costs and outcomes of a digital health application for patients with multiple sclerosis DOI Creative Commons
E. Walter,

Matthäus Traunfellner,

Franz Joachim Meyer

и другие.

Digital Health, Год журнала: 2025, Номер 11

Опубликована: Янв. 1, 2025

Objective Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease affecting 2.9 million people worldwide, often leading to permanent disability. MS patients frequently use eHealth tools due their relatively young age. The Floodlight ® app scientifically designed smartphone application that helps monitor hand motor skills, walking ability and cognition between medical appointments. This study assesses the cost-effectiveness of using alongside standard-of-care (SoC) versus SoC alone in with relapsing-remitting (RRMS) from perspective healthcare system. Methods A 10-year decision-analytic model was developed assess incorporating SoC. analysis included treatment-naive individuals those already on drug therapy, modelling app's role early detection progression relapses improve quality-of-life. Results For patients, resulted 2,660 € increase total costs but yielded potential medical-cost savings 786 through health improvements. These experienced fewer slower disability progression, translating quality-of-life improvement 4.5 months perfect an incremental-cost-effectiveness-ratio (ICER) 7,071 €. Pre-treated showed similar trends, 718 €, ICER 7,864 4.2 months. Higher effectiveness (+5%) led additional 8.3 reduction overall costs. Conclusion demonstrates cost-effective digital application, encouraging broader discussions maximizing software-as-medical-devices within care pathway.

Язык: Английский

Процитировано

1
Narrative Review on the Use of Cladribine Tablets as Exit Therapy for Stable Elderly Patients with Multiple Sclerosis DOI Creative Commons
de Sèze, Dominique Dive, Xavier Ayrignac

и другие.

Neurology and Therapy, Год журнала: 2024, Номер 13(3), С. 519 - 533

Опубликована: Апрель 8, 2024

The number of ageing people with relapsing multiple sclerosis (RMS) is increasing. efficacy disease-modifying therapies (DMTs) for RMS declines age. Also, older persons MS may be more susceptible to infections, hospitalisations and malignancy. Aging have higher rates comorbidities versus aged-matched controls, increasing the individual risk disability. We review therapeutic properties cladribine tablets (CladT) in RMS, regard their utility allowing these individuals cease continuous administration a DMT (i.e. act as an "exit therapy"). CladT thought immune reconstitution therapy, that two short courses oral treatment 1 year apart provide suppression disease activity responders far outlasts duration post-treatment reductions lymphocyte counts. Post hoc analyses, long-term follow-up populations randomised trials, real-world evidence suggest probably independent age, although data elderly are still needed. No clear adverse signals lymphopenia or other safety emerged immunosenescence setting age-related "inflammaging" predispose patients infections. Updating vaccination status recommended, especially against pneumococci herpes zoster patients, minimise useful alternative who often bear burden polypharmacy exposed effects immunosuppressive therapy.

Язык: Английский

Процитировано

4
Real World Experience with Cladribine Tablets for Multiple Sclerosis at Four Academic Multiple Sclerosis Centers DOI Creative Commons
Devon Conway,

Jacqueline A. Nicholas,

Nicolas R. Thompson

и другие.

Multiple Sclerosis and Related Disorders, Год журнала: 2025, Номер 94, С. 106272 - 106272

Опубликована: Янв. 14, 2025

Язык: Английский

Процитировано

0
Therapeutic choices and disease activity after 2 years of treatment with cladribine: An Italian multicenter study (CladStop) DOI Creative Commons
Irene Schiavetti, Alessio Signori,

Angela Albanese

и другие.

European Journal of Neurology, Год журнала: 2024, Номер 31(6)

Опубликована: Март 28, 2024

Abstract Background and purpose Cladribine tablets, a purine analogue antimetabolite, offer unique treatment regimen, involving short courses at the start of first second year, with no further needed in years 3 4. However, comprehensive evidence regarding patient outcomes beyond initial 24 months cladribine is limited. Methods This retrospective, multicenter study enrolled 204 patients multiple sclerosis who had completed 2‐year course treatment. The primary were therapeutic choices clinical disease activity assessed by annualized relapse rate after course. Results A total enrolled; most (75.4%) did not initiate new treatments 12 postcladribine. found significant reduction 12‐month follow‐up completion compared to year prior starting therapy (0.07 ± 0.25 vs. 0.82 0.80, p < 0.001). Furthermore, relapses during more likely therapies, whereas older less likely. safety profile was favorable, lymphopenia being registered adverse event. Conclusions provides insights into following It highlights cladribine's effectiveness reducing rates disability progression, reaffirming its favorable profile. Real‐world data, aligned previous reports, draw attention ocrelizumab natalizumab as common cladribine. larger, prospective studies for validation understanding long‐term impact are necessary.

Язык: Английский

Процитировано

2
Holistic, Long-Term Management of People with Relapsing Multiple Sclerosis with Cladribine Tablets: Expert Opinion from France DOI Creative Commons
Jonathan Ciron, Bertrand Bourre,

Giovanni Castelnovo

и другие.

Neurology and Therapy, Год журнала: 2024, Номер 13(3), С. 503 - 518

Опубликована: Март 15, 2024

Cladribine tablets (CladT) has been available for therapeutic use in France since March 2021 the management of highly active relapsing multiple sclerosis (RMS). This high-efficacy disease-modifying therapy (DMT) acts as an immune reconstitution therapy. In contrast to most DMTs, which act via continuous immunosuppression, two short courses oral treatment with CladT at beginning years 1 and 2 provide long-term control MS disease activity responders treatment, without need any further pharmacological several years. Although labelling does not guidance beyond initial courses, real-world data on from registries previous clinical trial participants patients treated routine practice indicate that is controlled a period this time substantial proportion patients. Moreover, experience provided useful information how initiate manage CladT. article we, group expert neurologists France, recommendations initiation DMT-naïve patients, switch existing DMTs continuing activity, during first finally, or 3, 4 after initiating We believe optimisation its will maximise benefits especially early course when suppression focal inflammation CNS priority limit progression.

Язык: Английский

Процитировано

1
Experience with the use of cladribine tablets in real-life clinical practice: independent analysis of data from 12 Russian clinical centres DOI Creative Commons
Alexey Boyко, В. М. Алифирова, D. V. Pashkovskaya

и другие.

Neurology neuropsychiatry Psychosomatics, Год журнала: 2024, Номер 16, С. 44 - 50

Опубликована: Авг. 7, 2024

Multiple sclerosis (MS) is an autoimmune-inflammatory and neurodegenerative disease of the central nervous system. The article analyses ability cladribine, which due to its selective lymphotoxic effect on activated cells immunomodulation in brain tissue underwent successful clinical trials 2010, when it was (temporarily) approved Russia. Objective: analyse cladribine tablets daily practice course MS over 3–4 year observational period after immune reconstitution therapy (IRT) several neurological clinics from different regions Material methods . We collected data 235 patients 12 regional centres who were followed for average 3.4 years starting treatment. Results. An independent analysis cases prescribed showed that reason prescribing highly active (HARS) 159 (67.7%) patients, rapidly progressive (RPMS) 20 (8.5%), relapsing-remitting – 50 (21.3%) secondary with exacerbations 6 (2.5%). Only (5.1%) these had not previously received disease-modifying therapies (DMTs), i.e. drug first DMT prescribed. Among a second-line DMTs before switching 22 natalizumab, 5 ocrelizumab only 1 fingolimod. Remaining (n=195) switched first-line DMTs. In all cases, decrease frequency observed during completion IRT course. Exacerbations between second 36 (15.3% treated patients), including almost half those natalizumab (17 or 47.2% exacerbations, developed therapy) three (8.3 % therapy, 60 cladribine). After full treatment four-year observation period, occurred 14 (6% included analysis), six natalizumab. Conclusion. results are generally consistent recently published meta-analyses reviews, but high likelihood such as noteworthy. Both drugs aggressive types (highly progressive) increase Expanded Disability Status Scale (EDSS) scores prior being drugs. switch usually increased risk developing multifocal encephalopathy titre antibodies against JC-virus duration natal izumab use more than 2 years. It likely resumption activity discontinuation quite pronounced, replacement tablet form able completely prevent this. this respect, does appear be optimal, contrast where cladribine.

Язык: Английский

Процитировано

0