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Cladribine in aggressive forms of multiple sclerosis
Author(s) -
MartinezRodriguez J. E.,
Cadavid D.,
Wolansky L. J.,
Pliner L.,
Cook S. D.
Publication year - 2007
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2007.01735.x
Subject(s) - cladribine , medicine , multiple sclerosis , expanded disability status scale , adverse effect , magnetic resonance imaging , gastroenterology , radiology , immunology
Cladribine (2‐chlorodeoxyadenosine) is an immunosuppressant drug previously evaluated in multiple sclerosis (MS) with variable results. We report six patients with aggressive relapsing MS who despite a poor response to other therapies had a favourable clinical evolution after cladribine. Four women and two men with a rapid increase in the number and severity of relapses leading to increasing disability [mean Expanded Disability Status Scale (EDSS) 6.42, standard deviation ± 0.58, mean relapse rate per year in the 2 years prior to study entry 2.67 ± 0.75] were retrospectively evaluated. Brain magnetic resonance imaging (MRI) performed in five patients showed active disease with gadolinium‐enhancing lesions. Cladribine was given at 0.07 mg/kg/day for five consecutive days once monthly with a total of 2‐ to 4‐monthly courses. After 6 months, mean EDSS decreased to 3.75 ± 1.64 and MRIs showed a decrease or suppression in the number of gadolinium‐enhancing lesions. After 1 year from first dose, cladribine dosage was repeated in four patients because of recurrence of relapses with subsequent similar positive clinical results. In the follow‐up period (49.33 ± 39.66 months), the mean relapse rate decreased to 0.71 ± 0.55 and no unexpected or serious adverse events were observed.