De-escalation from anti-CD20 to cladribine tablets in multiple sclerosis: A pilot study

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-28 DOI:10.1016/j.msard.2024.106145

Rosaria Sacco , Giulio Disanto , Emanuele Pravatà , Giulia Mallucci , Aleksandra Maleska Maceski , Jens Kuhle , Claudio Gobbi , Chiara Zecca

引用次数: 0

Abstract

Prolonged treatment with anti-CD20 antibodies can lead to hypogammaglobulinemia and increased infection risk in multiple sclerosis (MS). We investigated switch from anti-CD20 to cladribine as a strategy to prevent immunoglobulin reduction while preserving efficacy. We prospectively analysed serum IgG, IgM, neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in 44 patients, 14 who were switched from anti-CD20 to cladribine and 30 continuing anti-CD20. Over 1 year, serum IgG, IgM, NfL and GFAP remained stable after switch and similar to patients continuing anti-CD20. More than 90 % of patients remained free of disease activity. Cladribine should be further explored as de-escalating agent from anti-CD20 in MS.

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多发性硬化症患者从抗 CD20 降级到服用克拉利宾片：试点研究。

长期使用抗CD20抗体治疗会导致多发性硬化症（MS）患者出现低丙种球蛋白血症并增加感染风险。我们研究了将抗 CD20 转换为克拉利宾的策略，以防止免疫球蛋白减少，同时保持疗效。我们对 44 名患者的血清 IgG、IgM、神经丝蛋白（NfL）和胶质纤维酸性蛋白（GFAP）进行了前瞻性分析，其中 14 名患者从抗 CD20 转为使用克拉利宾，30 名患者继续使用抗 CD20。1年后，血清IgG、IgM、NfL和GFAP保持稳定，与继续抗CD20的患者相似。超过 90% 的患者仍无疾病活动。克拉德里滨应作为抗CD20治疗多发性硬化症的降级药物进行进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.