Identifying Cladribine prescription pattern in MS: an Italian multicentre study
Background: Characterizing Cladribine tablets prescription pattern in daily clinical practice is crucial for optimizing multiple sclerosis (MS) treatment. Objectives: To describe efficacy, safety profile and new disease-modifying therapy (DMT) prescriptions following Cladribine treatment. Design: In...
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Format: | Article |
Language: | English |
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SAGE Publishing
2025-01-01
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Series: | Therapeutic Advances in Neurological Disorders |
Online Access: | https://doi.org/10.1177/17562864241304212 |
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author | Aurora Zanghì Roberta Fantozzi Matteo Foschi Elisabetta Signoriello Matilde Inglese Giacomo Lus Diego Centonze Andrea Surcinelli Tommaso Sirito Simona Bonavita Carlo Avolio Emanuele D’Amico |
author_facet | Aurora Zanghì Roberta Fantozzi Matteo Foschi Elisabetta Signoriello Matilde Inglese Giacomo Lus Diego Centonze Andrea Surcinelli Tommaso Sirito Simona Bonavita Carlo Avolio Emanuele D’Amico |
author_sort | Aurora Zanghì |
collection | DOAJ |
description | Background: Characterizing Cladribine tablets prescription pattern in daily clinical practice is crucial for optimizing multiple sclerosis (MS) treatment. Objectives: To describe efficacy, safety profile and new disease-modifying therapy (DMT) prescriptions following Cladribine treatment. Design: Independent retrospective cohort study in patients followed at six Italian MS centres. Methods: Patients diagnosed with relapsing MS (RMS) according to 2017 McDonald criteria, who initiated Cladribine between January 2019 and May 2023, were included. A generalized linear regression model was built for the outcome DMT after Cladribine course. Heatmaps were generated based on weighted pivot tables to visualize the proportion of patients requiring DMT post-Cladribine. Results: A total cohort of 352 patients was enrolled, 134 naïve to any DMT, 218 switchers from other DMTs. The last DMT was an injectable first-line DMT for 48 (22%) patients, oral first-line DMT for 141 (64.7%) patients, SP1 inhibitor-Fingolimod for 23 (10.6%) patients, and Natalizumab for 6 (2.7%) patients. Overall, Cladribine was efficacious and well tolerated, 12% of patients required a new DMT prescription after a median time of 24 months. The regression model revealed that patients aged >40 years at Cladribine prescription had a 16% decrease in likelihood of receiving a new DMT. Heatmaps showed patients previously on Fingolimod had a lower rate (72.2%) of being free from therapy after Cladribine. Conclusion: In our multicentric real-world Italian study, Cladribine therapy is generally effective during the investigated follow-up period. Understanding key characteristics of patients responding best to Cladribine can help tailor therapeutic strategies for optimal outcomes. |
format | Article |
id | doaj-art-6fb6c93899ff412dbe6e285819d82843 |
institution | Kabale University |
issn | 1756-2864 |
language | English |
publishDate | 2025-01-01 |
publisher | SAGE Publishing |
record_format | Article |
series | Therapeutic Advances in Neurological Disorders |
spelling | doaj-art-6fb6c93899ff412dbe6e285819d828432025-01-08T15:03:28ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642025-01-011810.1177/17562864241304212Identifying Cladribine prescription pattern in MS: an Italian multicentre studyAurora ZanghìRoberta FantozziMatteo FoschiElisabetta SignorielloMatilde IngleseGiacomo LusDiego CentonzeAndrea SurcinelliTommaso SiritoSimona BonavitaCarlo AvolioEmanuele D’AmicoBackground: Characterizing Cladribine tablets prescription pattern in daily clinical practice is crucial for optimizing multiple sclerosis (MS) treatment. Objectives: To describe efficacy, safety profile and new disease-modifying therapy (DMT) prescriptions following Cladribine treatment. Design: Independent retrospective cohort study in patients followed at six Italian MS centres. Methods: Patients diagnosed with relapsing MS (RMS) according to 2017 McDonald criteria, who initiated Cladribine between January 2019 and May 2023, were included. A generalized linear regression model was built for the outcome DMT after Cladribine course. Heatmaps were generated based on weighted pivot tables to visualize the proportion of patients requiring DMT post-Cladribine. Results: A total cohort of 352 patients was enrolled, 134 naïve to any DMT, 218 switchers from other DMTs. The last DMT was an injectable first-line DMT for 48 (22%) patients, oral first-line DMT for 141 (64.7%) patients, SP1 inhibitor-Fingolimod for 23 (10.6%) patients, and Natalizumab for 6 (2.7%) patients. Overall, Cladribine was efficacious and well tolerated, 12% of patients required a new DMT prescription after a median time of 24 months. The regression model revealed that patients aged >40 years at Cladribine prescription had a 16% decrease in likelihood of receiving a new DMT. Heatmaps showed patients previously on Fingolimod had a lower rate (72.2%) of being free from therapy after Cladribine. Conclusion: In our multicentric real-world Italian study, Cladribine therapy is generally effective during the investigated follow-up period. Understanding key characteristics of patients responding best to Cladribine can help tailor therapeutic strategies for optimal outcomes.https://doi.org/10.1177/17562864241304212 |
spellingShingle | Aurora Zanghì Roberta Fantozzi Matteo Foschi Elisabetta Signoriello Matilde Inglese Giacomo Lus Diego Centonze Andrea Surcinelli Tommaso Sirito Simona Bonavita Carlo Avolio Emanuele D’Amico Identifying Cladribine prescription pattern in MS: an Italian multicentre study Therapeutic Advances in Neurological Disorders |
title | Identifying Cladribine prescription pattern in MS: an Italian multicentre study |
title_full | Identifying Cladribine prescription pattern in MS: an Italian multicentre study |
title_fullStr | Identifying Cladribine prescription pattern in MS: an Italian multicentre study |
title_full_unstemmed | Identifying Cladribine prescription pattern in MS: an Italian multicentre study |
title_short | Identifying Cladribine prescription pattern in MS: an Italian multicentre study |
title_sort | identifying cladribine prescription pattern in ms an italian multicentre study |
url | https://doi.org/10.1177/17562864241304212 |
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