Mavenclad (cladribine tablets), an oral therapy by Merck that’s approved to treat people with active relapsing multiple sclerosis in much of Europe, is a “smart therapy” that is showing real and long-term benefit after a short treatment course, said Gavin Giovannoni, chair of neurology at Barts and The London School of Medicine and Dentistry.
Giovannoni spoke with Multiple Sclerosis News Today about Mavenclad and its ability to reduce relapses and prevent the development of inflammatory lesions in these MS patients at the 7th Joint ECTRIMS-ACTRIMS Meeting in Paris, which concludes on Saturday.
A lead investigator in the CLARITY studies (NCT00213135 and NCT00641537) that evaluated the therapy, Giovannoni showed at ECTRIMS that a higher proportion of patients with active relapsing MS achieved NEDA with the treatment compared to placebo. NEDA stands for “no evidence of disease activity,” a composite measure that takes into account relapses, disability progression, and magnetic resonance imaging [MRI] activity.
“The relative chance of meeting NEDA is about 3.5 times greater with cladribine versus placebo,” Giovannoni said in the interview.
But, he added, this “is kind of a flawed comparison” because the baseline MRI scan of patients was compared against one taken two years post-treatment — resulting in 47 percent of patients reaching NEDA — while “the drug takes a bit of time to work.”
A team is currently doing a new analysis to compare the two-year post-treatment scans to six-month post-treatment scans — when Mavenclad’s effects should be at play. Giovannoni believes the results of this new analysis will be even better.
“Forty-seven percent is actually very, very good, two years compared to baseline. But I think it is going to get much, much better when we go to two years versus six months,” he said. Such results would place “cladribine at a very high efficacy record as a very effective therapy … giving people a chance of being activity-free and stopping them from having any relapses.”
Among other topics discussed in the interview were Mavenclad’s mechanism of action as an immune-reconstitution therapy, the timing of additional treatment courses should they be needed, and lymphopenia (an abnormally low level of lymphocytes in the blood) as an adverse effect of the drug — but one he was not overly worried about.
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