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Changes in lymphocytes, neutrophils and immunoglobulins in year-1 cladribine treatment in multiple sclerosis
European Journal of Neurology ; 29:475, 2022.
Article in English | EMBASE | ID: covidwho-1978467
ABSTRACT
Background and

aims:

Cladribine is a nucleoside analogue, approved for the treatment of active multiple sclerosis (MS). Looking at clinical trial results, during cladribine treatment, there is a marked and long-lasting CD19 B-cell depletion and a modest T-cell depletion. Immunoglobulin (Ig) levels were never explored. In our real-world study, we evaluated changes in lymphocytes, neutrophils and immunoglobulins over the first 12 months of cladribine treatment.

Methods:

This observational retrospective study has been conducted on prospectively collected data from 2018 to 2021. Clinical and laboratory data at baseline and after 2, 6 and 12 months were included.

Results:

Using baseline as reference, total lymphocyte count was lower after 2, 6, and 12 months. Neutrophils were lower after 2 and 6 months, but not after 12 months. We observed no changes in IgG, IgM and IgA over 12 months. CD19 B-cell count was lower after 2 and 6 months, but not after 12 months. CD8 T-cell count was lower after 2 and 6 months, but not after 12 months. CD4 T-cell count was lower after 2, and 6 months, but not after 12 months.

Conclusion:

We observed a significant decrease in total lymphocyte count from 2 months after cladribine treatment start until the end of year 1. After 12 months, we observed complete reconstitution of CD19 B-lymphocytes. Immunoglobulins remained stable over year-1 cladribine treatment that is also in line with observed normal antibody production to COVID-19 infection and vaccination in patients treated with cladribine.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: European Journal of Neurology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: European Journal of Neurology Year: 2022 Document Type: Article