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Cladribin-Tabletten bei schubförmiger Multipler Sklerose

Noch ein Purinanalogon oder echte therapeutische Innovation?

Oral cladribine for relapsing-remitting multiple sclerosis

Another purine analogue or a genuine therapeutic innovation?

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Zusammenfassung

Azathioprin (AZA) ist ein Purinanalogon, das seit über 30 Jahren in der Behandlung der Multiplen Sklerose (MS) eingesetzt wird. Nach Zulassung der immunmodulatorischen Basistherapien (rekombinantes Interferon-β und Glatiramerazetat) spielt AZA in der MS-Therapie jedoch nur noch eine untergeordnete Rolle. Die jüngst publizierten Daten einer Phase-III-Studie mit einer oralen Formulierung des Purinanalogons Cladribin („CLARITY-Studie“), einer AZA zumindest strukturell verwandten Substanz, könnten zur baldigen Zulassung von Cladribin-Tabletten als neues orales MS-Therapeutikum führen. Die folgende Übersicht gibt einen vergleichenden Überblick über Wirkmechanismus, Nebenwirkungsprofil und Datenlage von AZA und Cladribin in der Behandlung der MS.

Abstract

Azathioprine (AZA) is a purine analogue which has been used in the treatment of multiple sclerosis (MS) for over 30 years. After the approval of immunomodulatory drugs, such as recombinant interferon beta and glatiramer acetate, AZA now only plays a minor role in MS therapy. The results of a recently published phase III trial (CLARITY trial) involving an oral formulation of the purine analogue cladribine, a substance which is at least structurally related to AZA, may soon lead to the approval of cladribine tablets as a new oral MS therapeutic. The following overview provides a comparison of the mode of action, side-effect profile and data currently available on AZA and cladribine in the treatment of MS.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Die Studie wurde von Merck Serono und ACUMED unterstützt. Der Autor erhielt Vortragshonorare, Reisekosten- und Projektunterstützungen von Bayer Vital, Biogen Idec, Merck Serono, Sanofi Aventis und Teva Pharma.

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  1. Neurologische Gemeinschaftspraxis Bonn, Kölnstraße 480, 53117, Bonn, Deutschland

    S. Schmidt

  2. Neurologische Klinik, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Deutschland

    S. Schmidt

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Schmidt, S. Cladribin-Tabletten bei schubförmiger Multipler Sklerose. Nervenarzt 81, 1231–1241 (2010). https://doi.org/10.1007/s00115-010-3040-6

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