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Multiple Sclerosis – Cladribine tablets (Mavenclad)

This is a new guideline from NICE on a new treatment for MS. Obviously we won't be prescribing this, but I thought it worth mentioning as we may see patients starting to use it.

It is an oral medication, given as short courses (eg for 2 years, it is given for just a few days in each of a couple of months). This compares to other medications, which are either daily and continuous, or injections, or IV medications given in hospital.

It will be used as a second line treatment in relapsing-remitting MS, or in rapidly evolving severe relapsing-remitting MS.

If like me, you were a bit rusty on other treatment options, here are a few:

  • Fingolimod (Gilenya) - oral medication taken daily.
  • Teriflunomide (Aubagio) - oral medication taken daily.
  • Antibodies (eg the 'zumab' drugs) - given as infusions with varying frequency.
  • Interferons - self-injected at varying frequencies.
  • Dimethyl fumarate (Tecfidera) - oral medication taken BD.

I’m a freelance GP locum in Winchester & Southampton.

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