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The treatment of chronic progressive multiple sclerosis with cladribine.

Abstract
A 2-year, placebo-controlled, double-blind, crossover study was started in 1992 to evaluate cladribine, an immunosuppressive drug, in the treatment of chronic progressive multiple sclerosis. In the first year patients were given cladribine 0.10 mg/kg per day for 7 days as four monthly courses for a total of 2.8 mg/kg or placebo. During the second year patients treated with placebo during the first year were given i.v. infusions of 0.10 mg, 0.05 mg, and 0.05 mg of cladribine per kg of body weight per day for 7 consecutive days in three successive monthly courses, for a total dose of 1.4 mg/kg. Patients who had been treated previously with cladribine were crossed over to placebo. Analysis of the results revealed a favorable influence on the neurological performance scores, both in the Kurtze extended disability status and the Scripps neurological rating scale, and on MRI findings in patients treated with cladribine. In the first year the most striking finding was that while clinical deterioration continued in the placebo-treated patients, the condition of patients who received cladribine stabilized or even improved slightly. Toxicity and therapeutic response were dose-related.
AuthorsE Beutler, J C Sipe, J S Romine, J A Koziol, R McMillan, J Zyroff
JournalProceedings of the National Academy of Sciences of the United States of America (Proc Natl Acad Sci U S A) Vol. 93 Issue 4 Pg. 1716-20 (Feb 20 1996) ISSN: 0027-8424 [Print] United States
PMID8643695 (Publication Type: Clinical Trial, Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Immunosuppressive Agents
  • Cladribine
Topics
  • Adult
  • Cladribine (adverse effects, therapeutic use)
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Humans
  • Immunosuppressive Agents (adverse effects, therapeutic use)
  • Lymphocyte Count
  • Lymphocyte Subsets
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis (drug therapy, immunology, pathology)
  • Severity of Illness Index
  • Treatment Outcome

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