Emerging oral therapies for multiple sclerosis

Cohen, Bruce A.; Rieckmann, Peter

doi:10.1111/j.1742-1241.2007.01561..x

Cited by 55 publications

(43 citation statements)

References 86 publications

(116 reference statements)

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“…As has been reported for other diseases, long-term adherence to existing MS therapies is often poor [21]. Evidence suggests that early dropout from treatment occurs frequently within the first 6 months to 2 years of treatment initiation [21,22].…”

Section: Existing Ms Therapiesmentioning

confidence: 99%

Development of oral cladribine for the treatment of multiple sclerosis

et al. 2009

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Multiple sclerosis (MS) is a chronic immune-mediated disorder of the CNS in which autoreactive CD4+ and CD8+ T lymphocytes, B lymphocytes, antibodies, macrophages and cytokines synergize to attack myelin sheaths and injure underlying axons. Current disease-modifying drugs (DMDs) for MS require regular and frequent parenteral administration and are associated with limited long-term treatment adherence. Of all the potential new oral MS agents in development, cladribine is the only therapy with the potential for short-course dosing. Cladribine is an immunosuppressant that offers targeted, sustained regulation of the immune system and that has a well-characterized safety profile, derived from more than 15 years of use of the parenteral formulation in oncology indications and MS. This paper discusses the need for new MS therapies to improve treatment adherence, and reviews the mechanism of action, existing efficacy and safety data, and the clinical development of oral cladribine. The need for continuous risk monitoring for all new potent immunoactive drugs under development is emphasized. Preliminary results of the 96-week, double-blind, randomized, placebo-controlled, multicenter CLARITY (CLAdRIbine Tablets Treating MS OrallY) study are encouraging and provide the first complete phase III data on an oral DMD for MS.

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Section: Existing Ms Therapiesmentioning

confidence: 99%

Development of oral cladribine for the treatment of multiple sclerosis

et al. 2009

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“…In multiple sclerosis, for which no effective oral treatment was available until recently, injection anxiety or needle phobia could prevent patients from self-injecting their biologics [41]. Misunderstanding about the risks of self-injection or a lack of knowledge about how best to manage injection pain and side effects may also result in an inability to self-inject [41].…”

Section: Oral Administration Is a Major Advantage For Small Moleculesmentioning

confidence: 99%

Korean rheumatology workforce from 1992 to 2015: current status and future demand

Lee¹,

Kim²,

Kim³

et al. 2019

Korean J Intern Med

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Background: Until late in the 20th century, the therapy of rheumatic diseases relied on the use of drugs that had been developed through empirical approaches without detailed understanding of the molecular mechanisms involved. That approach changed with the introduction of biologic therapeutics at the end of the 20th century and by the recent development of small-molecule inhibitors of intracellular signal transduction pathways. Here we compare and discuss the advantages and disadvantages of those two groups of targeted anti-inflammatory therapeutics.

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“…However, in the later, more severe, stages of MS, patients are more likely to stop using treatment because of a perceived lack of efficacy. 30,33 With the new oral therapies, patient perceptions of poor efficacy and/or safety profiles compared with parenteral treatments may lead to an increased risk of poor treatment adherence in the form of missed or incorrect doses.…”

Section: The Present-day Ms Nurse-a Key Role In Adherencementioning

confidence: 99%

“…38 Although transitioning to oral therapy is unlikely to eradicate nonadherence, the introduction of therapies perceived by patients as more "friendly" may make patients more likely to initiate and adhere to these regimens, which in turn may lead to improved longterm disease outcomes. 33 Moreover, some therapies are currently being studied with annual dosing schedules, which would remove the demands for daily, weekly, or monthly treatment. 35,43,44 Such treatments will likely require reminder systems and treatment calendars (patients may forget to schedule a return visit to the physician after a long period of nontreatment) and extra vigilance with hematologic safety monitoring.…”

Section: The Changing Treatment Landscapementioning

confidence: 99%

The Evolving Role of the Multiple Sclerosis Nurse

Burke¹,

Dishon²,

McEwan³

et al. 2011

International Journal of MS Care

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A greater understanding of the pathogenesis of multiple sclerosis (MS) and the need for treatments with increased efficacy, safety, and tolerability have led to the ongoing development of new treatments. The evolution of treatments for MS is expected to have a dramatic impact on the entire health-care team, especially MS nurses, who build strong collaborative partnerships with their patients. MS nurses help patients better understand their disease and treatment options, facilitate the initiation and management of treatment, and encourage adherence. With new oral therapies entering the market, the potential for increased efficacy, tolerability, adherence, and convenience for patients is evident. However , the resulting change in the treatment paradigm means that the skill set required of an MS nurse will inevitably expand. There will be a growing need for professional training and development to ensure that nurses are familiar with the wider range of treatments and their specific modes of action, dosing schedules, and benefit/risk profiles. In addition, the MS nurse's role will expand to include management of the complex monitoring needs specific to each therapy. This article explores how the role of the MS nurse is evolving with the development of new MS therapies, including novel oral therapies. Int J MS Care. 2011;13:105-112.

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Emerging oral therapies for multiple sclerosis

Cited by 55 publications

References 86 publications

Development of oral cladribine for the treatment of multiple sclerosis

Development of oral cladribine for the treatment of multiple sclerosis

Korean rheumatology workforce from 1992 to 2015: current status and future demand

The Evolving Role of the Multiple Sclerosis Nurse

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