Prolonged observation after the use of cladribine in multiple sclerosis: efficacy and safety

A. D. Kukushkina, A. N. Boyko
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Abstract

Multiple sclerosis (MS) is a chronic disease whose pathogenesis is based on autoimmune neuroinflammatory and neurodegenerative components. The goal of therapy of MS is to reduce the risk of exacerbations and progression of the disease. In recent years, treatment options have expanded significantly with the advent of a greater number of highly effective drugs that alter the course of MS (disease-modyfyung therapies, DMTs) and in the context of the development of a new direction – immune reconstitution therapy (IRT). IRT has a number of advantages, including short treatment courses with long-term effects on immune mechanisms. Cladribine tablets are a selective, highly effective oral form of IRT for MS patients with exacerbations that targets lymphocytes while preserving innate immune cells. Given the increasing number of patients receiving cladribine therapy, questions are increasingly being raised about further tactics for managing these patients, particularly in cases of persistent disease activity despite ongoing pathogenetic therapy. In this review, we publish the results of the consensus opinion of international experts on the analysis of long-term experience with cladribine.
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克拉德里滨治疗多发性硬化症后的长期观察:疗效和安全性
多发性硬化症(MS)是一种慢性疾病,其发病机制是基于自身免疫性神经炎症和神经退行性成分。治疗多发性硬化症的目标是降低疾病恶化和进展的风险。近年来,随着大量改变多发性硬化病程的高效药物(疾病改变疗法,DMTs)的出现,以及免疫重建疗法(IRT)这一新方向的发展,治疗选择显著扩大。IRT有许多优点,包括治疗疗程短,对免疫机制有长期影响。克拉德滨片是一种选择性的、高效的口服IRT,用于多发性硬化症加重患者,靶向淋巴细胞,同时保留先天免疫细胞。鉴于越来越多的患者接受克拉德滨治疗,对这些患者的进一步管理策略提出了越来越多的问题,特别是在持续进行病理治疗的情况下,疾病持续活动的情况下。在这篇综述中,我们发表了国际专家对长期使用克拉宾的一致意见的分析结果。
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