Recommendations for the use of cladribine tablets for the pathogenetic treatment of patients with highly active multiple sclerosis

Bakhtiyarova, K. Z.; Boyko, A. N.; Vlasov, Ya. V.; Гончарова, З. А.; Davydovskaya, M. V.; Zakharova, M. N.; Malkova, N A; Nilov, A. I.; Сиверцева, С А; Спирин, Н Н; Totolyan, Natalia; Хабиров, Ф. А.; Shumilina, Maria

doi:10.14412/2074-2711-2020-3-93-99

Cited by 2 publications

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“…В Российской Федерации кладрибин в таблетках (Мавенклад ® ) показан для лечения взрослых пациентов с ВАРС, подтвержденным данными клинических и радиологических исследований [13], а именно: 1) пациентам с одним обострением в течение предшествующего года и по крайней мере одним накапливающим контрастное вещество (Gd+) очагом или девятью и более выявляемыми на Т2-ВИ очагами на фоне проводимой терапии другим ПИТРС; 2) пациентам с двумя или более обострениями в течение предшествующего года, независимо от того, проводилась терапия ПИТРС или нет. Клинические ситуации, когда кладрибин в таблетках рекомендован и может быть одним из препаратов выбора, следующие [14]:…”

Section: Recommendations For Switching Patients With Highly Active Muunclassified

“…Современные высокоэффективные ПИТРС, действие которых часто основано на хронической иммуносупрессии и может быть сопряжено с нежелательными нарушениями иммунного надзора, в большинстве случаев принято назначать в качестве терапии второй линии, при неэффективности базовой терапии. Но в отношении пациентов с ВАРС возможно и целесообразно использование высокоэффективных ПИТРС как терапии первой линии, Ф А Р М А К О Т Е Р А П И Я 14,15 , Spirin N.N. 10 , Khabirov F.A.…”

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Recommendations for switching patients with highly active multiple sclerosis from other disease modifying drugs for multiple sclerosis to cladribine tablets

Totolyan

Алифирова

Bakhtiyarova

et al. 2020

RJTAO

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The need for optimal treatment of the active forms of multiple sclerosis (MS), especially highly active MS (HAMS), poses a number of difficult problems for specialists, including not only the choice of a highly effective disease-modifying drug for MS (DMDMS), but also conditions for the timely and safe switching from other DMDMS. A group of expert neurologists from various clinics in Russia presents a consensus on the practical aspects of switching patients with HAMS from other DMDMS to cladribine tablets, which has been registered in Russia in March 2020. The paper discusses indications for changing therapy and gives indications, contraindications, and conditions for initiating cladribine therapy. It details the procedure and results of the expert consensus, on the basis of which the recommendations have been developed to switch to cladribine tablets from each of the DMDMS registered in Russia for the treatment of MS.

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Section: Recommendations For Switching Patients With Highly Active Muunclassified

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Recommendations for switching patients with highly active multiple sclerosis from other disease modifying drugs for multiple sclerosis to cladribine tablets

Totolyan

Алифирова

Bakhtiyarova

et al. 2020

RJTAO

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Safety of pathogenetic therapy for multiple sclerosis during the COVID-19 pandemic

Петров

Вотинцева

Stolyarov

2022

Annals of Clinical and Experimental Neurology

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The safety of pathogenetic therapy for multiple sclerosis (MS) is a crucial aspect of the therapeutic strategy during the COVID-19 pandemic. Based on our own data, obtained during the study of MS pathogenesis and safety analysis of MS disease-modifying therapies (DMTs), we hereby suggest a classification of DMTs side effects, based on their type, development, and direction of action. There is a need to thoroughly analyse adverse events caused by pathogenetic therapy, with a balanced assessment of the direct vs. adverse effects of immunosuppressive drugs. Based on available literature, in the article, data on the effect of DMTs with various mechanisms of action on severe coronavirus infection are systematized. Interferon- and glatiramer acetate are the safest drugs to use during the COVID-19 pandemic. Teriflunomide, dimethyl fumarate, natalizumab, ocrelizumab, fingolimod, alemtuzumab, and cladribine should be used with caution. Drugs with a minor systemic immunosuppressant effect (e.g. natalizumab) and selective immunosuppressants (e.g. ocrelizumab) are safer than drugs that cause non-selective depletion of T and B cells. It must be stressed that the risk of MS exacerbation and progression due to untimely prescription or cessation of pathogenetic therapy can significantly exceed the potential risk of COVID-19. Long-term safety monitoring is required for DMTs during the COVID-19 pandemic and when the epidemiological situation stabilizes.

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Recommendations for the use of cladribine tablets for the pathogenetic treatment of patients with highly active multiple sclerosis

Cited by 2 publications

References 12 publications

Recommendations for switching patients with highly active multiple sclerosis from other disease modifying drugs for multiple sclerosis to cladribine tablets

Recommendations for switching patients with highly active multiple sclerosis from other disease modifying drugs for multiple sclerosis to cladribine tablets

Safety of pathogenetic therapy for multiple sclerosis during the COVID-19 pandemic

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