lymphopenia

Sharp lymphocyte drop seen quickly in SPMS patients on Mayzent

Some people with secondary progressive multiple sclerosis (SPMS) using Mayzent (siponimod) show a severe drop in their number of lymphocytes, a condition known as lymphopenia, shortly after starting treatment, a report on its real-world use in the U.K. found. Lymphocytes are white blood cells that help the immune…

Need to Know: Blood Tests and Multiple Sclerosis

Editor’s note: “Need to Knowā€ is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the post “Is It a Multiple Sclerosis Diagnosis or Something Else?” from July 20, 2018.

Cladribine Added to Interferon-beta Seen to Lower Relapses in Active MS, But Safety Questioned

Cladribine tablets added to interferon-beta treatment significantly reduced the probability of relapses over 96 weeks in people with active relapsing multiple sclerosis , a Phase 2 clinical trial found. But a troubling diminishment in key immune cells was also seen in treated patients. Relapsing-remitting MS is marked by periods of flares caused by inflammatory attacks, followed by periods of partial or complete recovery . A majority --about 65 percent -- go on to developĀ secondary progressive MS. Despite the growing number of treatment options ā€” including disease-modifying therapies ā€” for these MS patients, efforts continue into better ways to lower relapse frequency and slow disease progression. Researchers tested the safety and efficacy of cladribine tablets as an add-on therapy in patients continuing to experience active relapses while under interferon-betaĀ treatment. Cladribine is an oral medication that works by selectively targeting and reducing the number of immune cells involved in the inflammatory attacks occurring in active MS. It wasĀ developed byĀ EMD Serono (Merck KGaA outside the U.S. and Canada) and approved in the European Union using theĀ brand name MavencladĀ (it is not approved in the U.S. for MS). Interferon-beta works by balancing pro- and anti-inflammatory signals, reducing the number of immune cells and promoting the survival of nerve cells. Interferon-beta therapies are marketed under several brand names; in the study, researchers analyzed patients usingĀ Rebif (marketed by EMD Serono), Avonex (byĀ Biogen), and Betaseron/Betaferon (byĀ Bayer). The 96-week, randomized, double-blind, Phase 2b trial called ONWARD enrolled a total of 172 patients with active relapsing MS, who were randomly divided into two groups: those given cladribine tablets together with interferon-beta, and those that received a placebo and interferon-beta. Results showed those taking cladribine tablets together with interferon-beta had 63% lower likelihood of a relapse compared to those given an add-on placebo. Add-on cladribine treatment also reduced most measures of disease activity as assessed by magnetic resonance imaging (MRI) ā€” namely, the number of new brain and spinal cord lesions. However, almost half of patients in this treatment group developed lymphopenia, a conditionĀ where the levels of lymphocytes (important immune white blood cells) in the blood are abnormally low. None in the control group developed the condition. Other reported side effects, including other serious adverse side effects, were identical in the two groups. Altogether, the findings indicate that a cladribine and interferon-beta combination can successfully lower the probability of relapses over the course of 96 weeks, but also increase a person's chances of lymphopenia.

MS Treatments May Lower Levels of Immune White Blood Cells

Multiple sclerosis patients are at risk ofĀ developing lymphopenia, or abnormally low levels of immune defense white blood cells, called lymphocytes, according to a study that investigatedĀ lymphocyte counts in people with relapsing MS both before and after the start of treatment. The study, ā€œLymphopenia in treatment-naive relapsing multiple…