The effect of cladribine on immunoglobulin levels compared to B cell targeting therapies in multiple sclerosis.
Mult Scler J Exp Transl Clin
; 9(1): 20552173221149688, 2023.
Article
em En
| MEDLINE
| ID: mdl-36636583
ABSTRACT
Background:
Cladribine is a useful therapeutic option in RRMS with moderate to high disease activity. Its oral formulation and tolerability make it a useful alternative to infusion therapies. Cladribine is known to deplete CD19+ B lymphocytes, but its effect on immunoglobulin subsets is unclear.Objective:
To identify whether cladribine therapy in pwMS reduces immunoglobulin subset levels as a surrogate marker of infection risk.Methods:
A 'real-world' retrospective analysis of 341 pwMS presenting to a single tertiary centre between March 2017 and July 2021. Differences in immunoglobulin levels between cladribine, other disease-modifying therapies and no active treatment were assessed using a univariate ANOVA.Results:
Three hundred and forty-one patients had immunoglobulin levels assessed, with 29 patients treated with cladribine. The mean IgG, IgM and IgA levels on cladribine therapy were 10.44 ± 0.40, 0.99 ± 0.09 and 2.04 ± 0.18â g/L respectively. These were not significantly different from patients not on active treatment. There was a statistically significant reduction in IgG and IgM levels for patients treated with ocrelizumab (9.37 ± 0.19 and 0.68 ± 0.04â g/L) and natalizumab (8.72 ± 0.53 and 0.69 ± 0.12â g/L) compared to patients not on treatment.Conclusion:
Cladribine therapy for RRMS was not associated with immunoglobulin subset deficiencies. This is contrasted to ocrelizumab and natalizumab which demonstrate significant reductions in both IgG and IgM levels.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Mult Scler J Exp Transl Clin
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Austrália