Early use of cladribine tablets for relapsing-remitting multiple sclerosis: Expert opinion
E. V. Popova,
M. V. Abroskina,
K. Z. Bakhtiyarova,
Ya. V. Vlasov,
M. V. Davydovskaia,
E. P. Evdoshenko,
D. S. Korobko,
A. I. Nilov,
M. V. Sutormin,
Yu. V. Trinitatskiy,
F. A. Khabirov,
G. E. Sheiko,
M. V. Shumilina https://doi.org/10.21518/ms2024-321
Abstract
In March 2020, oral cladribine was licensed in Russian Federation for the treatment of adult patients with highly active relapsing multiple sclerosis as defined by clinical or imaging features. Three years after the introduction into the Russian market, practical aspects in the use of cladribine tablets we evaluated, including data from real-world studies and the experience gained in the own routine clinical practice. Early initiation of cladribine therapy, use of cladribine in treatment naïve patients and patients with suboptimal response to previous disease-modifying therapy, use of cladribine as the treatment of choice in patients with suboptimal response to platform disease-modifying therapy and washout period while switching to cladribine from other disease-modifying therapy. During the discussion thirteen neurologists from federal and regional centers experienced in multiple sclerosis diagnosis and therapy were asked to answer several questions regarding the practical use of cladribine tables and come to consensus opinion. Consent was reached if at least 75% of the experts agreed on a particular statement. The experts agreed on the possibility to switch patients to cladribine from platform disease-modifying therapy in case of MRI activity or neutralizing antibodies in the absence of relapses activity to achieve better disease control, potential cladribine effects on progression independent of relapses, washout period reduction while switching from natalizumab to cladribine. Consensus opinion will help to manage practical questions regarding cladribine usage.
About the Authors
E. V. Popova
City Clinical Hospital No. 24; Pirogov Russian National
Research Medical University
Russian Federation
Russian Federation
Ekaterina V. Popova, Dr. Sci. (Med.), Head of the Interdistrict Department of Multiple Sclerosis; Associate Professor of the Department of Neurology, Neurosurgery and Medical Genetics
10, Pistsovaya St., Moscow, 127015
1, Ostrovityanov St., Moscow, 117997
M. V. Abroskina
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital
Russian Federation
Russian Federation
Mariia V. Abroskina, Cand. Sci. (Med.), Associate Professor of the Department of Nervous Diseases with a Course of Postgraduate Education
1, Partizan Zheleznyak St., Krasnoyarsk, 660022
34B, Karl Marx St., Krasnoyarsk, 660049
K. Z. Bakhtiyarova
Bashkir State Medical University; Republican Clinical Hospital named after G.G. Kuvatov
Russian Federation
Russian Federation
Klara Z. Bakhtiyarova, Dr. Sci. (Med.), Professor of the Department of Neurology; Head, Republican Center for Multiple Sclerosis
3, Lenin St., Ufa, 450008
132, Dostoevsky St., Ufa, 450000
Ya. V. Vlasov
Samara State Medical University
Russian Federation
Russian Federation
Yan V. Vlasov, Dr. Sci. (Med.), Professor of the Department of Neurology and Neurosurgery; Member of the Human Rights Council under the President of the Russian Federation, co-chairman of the All- Russian Union of Patients, head of the Council of Public Organizations for the Protection of Patients’ Rights under Roszdravnadzor
89, Chapaevskaya St., Samara, 443099
M. V. Davydovskaia
City Clinical Hospital No. 24; Pirogov Russian National Research Medical University; Scientific and Practical Center for Clinical and Economic Analysis of the Ministry of Health of the Moscow Region
Russian Federation
Russian Federation
Maria V. Davydovskaia, Dr. Sci. (Med.), Professor of the Department of Neurology, Neurosurgery and Medical Genetics; Deputy Chief Freelance Neurologist of the Moscow Department of Health, Deputy Director for Science; Neurologist of the Interdistrict Department of Multiple Sclerosis
10, Pistsovaya St., Moscow, 127015
1, Ostrovityanov St., Moscow, 117997
4, lit. A, room 20, Karbysheva St., Moscow Region, Krasnogorsk, 143403
E. P. Evdoshenko
City Clinical Hospital No. 31
Russian Federation
Russian Federation
Evgeniy P. Evdoshenko, Cand. Sci. (Med.), Head of the St Petersburg City Center for Multiple Sclerosis and Other Autoimmune Diseases
3, Dynamo Ave., St Petersburg, 197110
D. S. Korobko
State Novosibirsk Regional Clinical Hospital; Novosibirsk State Medical University; Institute “International Tomography Center of the Siberian Branch of the Russian Academy of Sciences”
Russian Federation
Russian Federation
Denis S. Korobko, Cand. Sci. (Med.), Head of the Regional Center for Multiple Sclerosis and Other Autoimmune Diseases of the Nervous System; Assistant of the Department of Clinical Neurology and Neurogeriatrics; Senior Researcher of the Laboratory of Neurosciences
126, Nemirovich-Danchenko St., 630087, Novosibirsk
52, Krasny Ave., Novosibirsk, 630091
3A, Institutskaya St., Novosibirsk, 630090
A. I. Nilov
Samara Regional Clinical Hospital named after V.D. Seredavin
Russian Federation
Russian Federation
Aleksej I. Nilov, Neurologist of the Highest Category
159, Tashkentskaya St., Samara, 443095
M. V. Sutormin
Moscow Regional Research Clinical Institute named after M.F. Vladimirsky
Russian Federation
Russian Federation
Maksim V. Sutormin, Chief Freelance Specialist Neurologist of the Moscow Region, Head of the Neurology and Rehabilitation Service
61/2, Shchepkin St., Moscow, 129110
Yu. V. Trinitatskiy
Rostov Regional Clinical Hospital
Russian Federation
Russian Federation
Yuriy V. Trinitatskiy, Dr. Sci. (Med.), Professor, Doctor of the Highest Category, Honored Doctor of the Russian Federation, Director of the Center for Neurology
170, Blagodatnaya St., Rostov-on-Don, 344015
F. A. Khabirov
Kazan State Medical Academy – a branch of the Russian Medical Academy of Continuing Professional Education; Republican Neurological Center
Russian Federation
Russian Federation
Farit A. Khabirov, Dr. Sci. (Med.), Honored Scientist of the Republic of Tatarstan, Honored Doctor of the Russian Federation, Head; Professor, Head of the Department of Neurology
11, Mushtari St., Kazan, 420012
30A, Adoratsky St., Kazan, 420132
G. E. Sheiko
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Gennadii E. Sheiko, Cand. Sci. (Med.), Chief Freelance Neurologist of Nizhny Novgorod, Associate Professor of the Department of Medical Rehabilitation
18/1, Verkhnevolzhskaya Emb., Nizhny Novgorod, 603155
M. V. Shumilina
City Clinical Hospital No. 31
Russian Federation
Russian Federation
Maria V. Shumilina, Cand. Sci. (Med.), Head of the Outpatient Department of the St Petersburg City Center for Multiple Sclerosis and Other Autoimmune Diseases
3, Dynamo Ave., St Petersburg, 197110
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Review
For citations:
Popova EV, Abroskina MV, Bakhtiyarova KZ, Vlasov YV, Davydovskaia MV, Evdoshenko EP, Korobko DS, Nilov AI, Sutormin MV, Trinitatskiy YV, Khabirov FA, Sheiko GE, Shumilina MV. Early use of cladribine tablets for relapsing-remitting multiple sclerosis: Expert opinion. Meditsinskiy sovet = Medical Council. 2024;(12):101–107. (In Russ.) https://doi.org/10.21518/ms2024-321
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