Mavenclad, whose active ingredient is cladribine, is a medication used to treat relapsing forms of multiple sclerosis (MS), including relapsing-remitting MS and active secondary progressive MS. Its main goal is to reduce the progression of disability caused by MS and to control the disease activity that leads to worsening symptoms over time.
Multiple sclerosis is a chronic neurological condition where the immune system mistakenly attacks the protective covering of nerve fibers in the central nervous system. This leads to inflammation, nerve damage, and eventually disability. Disability in MS can accumulate gradually, sometimes independent of obvious relapses or flare-ups, making it crucial to find treatments that not only reduce relapses but also slow or prevent long-term disability progression.
Mavenclad works by selectively targeting certain immune cells, specifically lymphocytes, which play a key role in the autoimmune attack on the nervous system. It causes a dose-dependent reduction in lymphocyte counts, reaching the lowest levels about 2 to 3 months after each treatment cycle. This immune modulation helps reduce the inflammatory activity that drives MS relapses and nerve damage. Importantly, the drug is given in short courses over two years, but its effects on the immune system and disease activity can last much longer.
Clinical studies involving over a thousand patients have shown that Mavenclad significantly reduces the number of MS relapses compared to placebo. For example, after about two years, 81% of patients treated with Mavenclad remained relapse-free, compared to 63% of those who did not receive the drug. This reduction in relapses is important because each relapse can contribute to accumulating disability.
Beyond controlling relapses, Mavenclad also impacts disability progression itself. Data from long-term studies over four years indicate that a large majority of patients treated with Mavenclad did not experience confirmed disability progression. Specifically, about 83% of patients remained free from confirmed disability progression at four years, and nearly 90% were free from progression independent of relapse activity. This means that Mavenclad helps prevent the gradual worsening of disability even when patients do not have obvious relapses.
Moreover, some patients experienced confirmed disability improvement, with around 15% showing measurable improvement in their disability status. This suggests that Mavenclad may not only halt worsening but also allow some recovery of function in certain cases.
Age appears to influence outcomes, with patients 40 years or younger showing lower rates of disability progression independent of relapse activity compared to older patients. This highlights the potential benefit of starting treatment earlier in the disease course.
Mavenclad’s benefits extend to reducing markers of neuroinflammation in the central nervous system. Studies measuring biomarkers in the blood and cerebrospinal fluid found reductions in proteins associated with inflammation and nerve damage after treatment. This suggests that Mavenclad may provide a broader protective effect on the nervous system beyond just controlling relapses.
The drug’s dosing schedule is designed for convenience and safety. It is administered orally in two short courses over two years, with each course divided into two cycles. After these courses, no continuous treatment is usually needed, but patients are monitored for long-term effects. The active drug itself does not remain in the body beyond about a week after administration, but its immune effects persist much longer.
Because Mavenclad is a cytotoxic drug, meaning it can affect rapidly dividing cells, it requires careful monitoring before and during treatment. Patients undergo assessments including standard cancer screenings and blood tests to ensure safety. It is generally recommended for patients who have not responded well to or cannot tolerate other MS treatments, given its safety profile.
Some patients who have switched to Mavenclad after other treatments experienced improvements in symptoms such as fatigue and sensory problems, and reported better quality of life and ability to work. MRI scans in these patients often show stable disease activity, with no new lesions developing after treatment.
While Mavenclad is effective in reducing relapses and slowing disability progression, it is not without risks. Because i
