Holistic, Long-Term Management of People with Relapsing Multiple Sclerosis with Cladribine Tablets: Expert Opinion from France.

Cladribine tablets Disease-modifying therapy Holistic management Multiple sclerosis

Journal

Neurology and therapy
ISSN: 2193-8253
Titre abrégé: Neurol Ther
Pays: New Zealand
ID NLM: 101637818

Informations de publication

Date de publication:
15 Mar 2024
Historique:
received: 17 11 2023
accepted: 09 02 2024
medline: 15 3 2024
pubmed: 15 3 2024
entrez: 15 3 2024
Statut: aheadofprint

Résumé

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

Identifiants

pubmed: 38488979
doi: 10.1007/s40120-024-00589-7
pii: 10.1007/s40120-024-00589-7
doi:

Types de publication

Journal Article Review

Langues

eng

Informations de copyright

© 2024. The Author(s).

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Auteurs

Jonathan Ciron (J)

Department of Neurology, Centre de Ressources et de Compétences Sclérose en Plaques (CRC-SEP), Toulouse University Hospital, Hôpital Pierre-Paul Riquet, Toulouse, France.
INSERM UMR1291, CNRS UMR5051, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III, Toulouse, France.

Bertrand Bourre (B)

CHU Rouen, Department of Neurology, 76000, Rouen, France.

Giovanni Castelnovo (G)

Department of Neurology, Nîmes University Hospital, Hopital Caremeau, Nîmes, France.

Anne Marie Guennoc (AM)

Department of Neurology, CRC SEP, CHU Tours, 37000, Tours, France.

Jérôme De Sèze (J)

Department of Neurology, Strasbourg University Hospital, Strasbourg, France.

Ali Frederic Ben-Amor (AF)

Knowlepsy Investment, Marseille Innovation, Technopôle de Château-Gombert, Marseille, France.

Carine Savarin (C)

Merck Santé S.A.S., an Affiliate of Merck KGaA, Lyon, France.

Patrick Vermersch (P)

Univ. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, France. patrick.vermersch@univ-lille.fr.

Classifications MeSH