Долгосрочное наблюдение за пациентами с первым клиническим демиелином (клинический изолированный синдром), которые получили кладрибинные таблетки в CLASSIC-MS: выводы для группы ORACLE-MS.
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Giovannoni Gavin, Boyko Alexey, Correale Jorge, Edan Gilles, Freedman Mark S, Montalban Xavier, Rammohan Kottil, Stefoski Dusan, Yamout Bassem, Leist Thomas, Aydemir Aida, Borsi Laszlo, Verdun di Cantogno Elisabetta
Аннотация
Оригинал публикации
Long-term follow-up of patients with a first clinical demyelinating event (clinically isolated syndrome) who received cladribine tablets in CLASSIC-MS: Findings for the ORACLE-MS cohort.
BACKGROUND: CLASSIC-MS explored long-term outcomes of patients treated with cladribine tablets.
OBJECTIVE: Assess long-term efficacy in patients previously enrolled in ORACLE-MS, a Phase III parent trial.
METHODS: ORACLE-MS included patients with a first clinical demyelinating event (FCDE or clinically isolated syndrome) who received ⩾1 course of cladribine tablets or placebo. With a median follow-up time of 9.5 years, CLASSIC-MS assessed conversion rates to clinically definite multiple sclerosis (CDMS), time-to-conversion, relapse rates, long-term mobility/disability status and subsequent disease-modifying therapy (DMT) use.
RESULTS: Of 227 patients from the ORACLE-MS cohort of 616, 68.7% were exposed to cladribine tablets and 31.3% were never exposed. Of the exposed patients at risk, 51.5% converted to CDMS with a median conversion time of 8.4 (95% confidence interval (CI): 5.4-not estimable) years, versus 80.6%, median time 0.8 (95% CI: 0.3-2.4) years, for never exposed. Exposed patients were less likely to be using a wheelchair or ambulatory device or receive subsequent DMTs, and 53.2% were relapse-free versus 28.2% never exposed.
CONCLUSIONS: Proportionally, more FCDE patients exposed to cladribine tablets experienced delayed conversion to CDMS and fewer relapses and were less likely to use a wheelchair or ambulatory device than never-exposed patients, at 9.5 years (median).