Contributions
Abstract: EP1538
Type: ePoster
Abstract Category: Therapy - disease modifying - Treatment of progressive MS
Objective: To evaluate the safety and efficacy of Cladribine in patients with rapidly evolving or early secondary progressive MS (SPMS).
Background: Cladribine is efficacious in early and late relapsing MS but has not found a place in current treatment algorithms. Because its safety profile is better compared with other chemotherapeutic agents, we used it to treat relapsing patients with rampant disease or those with significant breakthrough on other disease modifying treatments (DMT) evolving to SPMS.
Methods: 24 patients (median EDSS 4.5 received Cladribine 0.07 mg/kg/day for 4 consecutive days every 6 months for ≥2 cycles with further cycles depending on lymphocyte recovery or continued disease activity to a maximum of 8 cycles. 4 patients presented with aggressive MS and were induced with Cladribine before any further DMT. The other 20 received Cladribine following disease breakthrough. We evaluated patients in terms of their outcome (relapse, EDSS and MRI).
Results: Patients (n=24; age range 30-60; 80% female) were followed for a median 7 years. (3 patients unavailable >7 years). The mean relapse rate in the 2 years before Cladribine was 1.25. 20/24 received multiple (≥2) prior DMT.
Following Cladribine there were 10 relapses in 8 (33.3%) patients. ARR reduced from1.25 to 0.42. In terms of mean EDSS, 16 % deteriorated, 62% did not change and 12.5% improved. New MRI activity (new T2 or Gad+ lesions) was seen in 7.
In terms of safety, there were 3 severe systemic infections that led to termination of the medication in one; 5 mild infections (UTI, URTI); 8 developed prolonged lymphopenia that delayed further dosing: 1 patient developed basal cell carcinoma.
Conclusion: Cladribine reduced the relapse rate, MRI activity and slowed disease progression in patients with rapidly evolving or early SPMS and therefore should be considered a treatment option for this more resistant form of disease.
Disclosure: nothing to disclose
Abstract: EP1538
Type: ePoster
Abstract Category: Therapy - disease modifying - Treatment of progressive MS
Objective: To evaluate the safety and efficacy of Cladribine in patients with rapidly evolving or early secondary progressive MS (SPMS).
Background: Cladribine is efficacious in early and late relapsing MS but has not found a place in current treatment algorithms. Because its safety profile is better compared with other chemotherapeutic agents, we used it to treat relapsing patients with rampant disease or those with significant breakthrough on other disease modifying treatments (DMT) evolving to SPMS.
Methods: 24 patients (median EDSS 4.5 received Cladribine 0.07 mg/kg/day for 4 consecutive days every 6 months for ≥2 cycles with further cycles depending on lymphocyte recovery or continued disease activity to a maximum of 8 cycles. 4 patients presented with aggressive MS and were induced with Cladribine before any further DMT. The other 20 received Cladribine following disease breakthrough. We evaluated patients in terms of their outcome (relapse, EDSS and MRI).
Results: Patients (n=24; age range 30-60; 80% female) were followed for a median 7 years. (3 patients unavailable >7 years). The mean relapse rate in the 2 years before Cladribine was 1.25. 20/24 received multiple (≥2) prior DMT.
Following Cladribine there were 10 relapses in 8 (33.3%) patients. ARR reduced from1.25 to 0.42. In terms of mean EDSS, 16 % deteriorated, 62% did not change and 12.5% improved. New MRI activity (new T2 or Gad+ lesions) was seen in 7.
In terms of safety, there were 3 severe systemic infections that led to termination of the medication in one; 5 mild infections (UTI, URTI); 8 developed prolonged lymphopenia that delayed further dosing: 1 patient developed basal cell carcinoma.
Conclusion: Cladribine reduced the relapse rate, MRI activity and slowed disease progression in patients with rapidly evolving or early SPMS and therefore should be considered a treatment option for this more resistant form of disease.
Disclosure: nothing to disclose