What Are The Side Effects Of Cladribine
Cladribine doesnt weaken your immune system as much as some other MS drugs. So the risk of getting infections isnt as high as with some DMTs.
The most common side effect is a drop in the number of your white blood cells that fight infections . This is seen in about one in four to one in three people. Cladribine is meant to make this happen but this drop can last a long time and be severe.
Other side effects can include a slightly higher risk of getting headaches, colds, and infections caused by the herpes viruses. This includes the skin rash shingles, which one in 50 people on the drug get. Youll be vaccinated against some infections like chicken pox before you take cladribine. About three in 100 people get some hair loss or thinning of their hair.
An earlier study seemed to show a higher risk of cancer but we now know this isn’t the case.
How Well Does Cladribine Work
MS drugs can be put into three groups based on how well they control it. The effectiveness of cladribine is classed as ‘good’. This puts it between the DMTs classed as ‘high’ effectiveness and those classed as ‘moderate’. This is based on how much it reduces relapses and slows down how fast people’s disability gets worse.
In a large trial:
Does Tysabri Cause Hair Loss
If you have hair loss during treatment with Tysabri, its probably not caused by the drug. In studies, hair loss wasnt a side effect reported in people receiving Tysabri.
Keep in mind that Tysabri is used to treat multiple sclerosis or Crohns disease. Hair loss can be triggered by other factors related to these conditions, such as stress and other prescribed medications.
Also, some people with Crohns disease have trouble absorbing essential vitamins and minerals from their diet. This can lead to nutrient deficiencies, another possible reason for hair loss.
If youre having hair loss, talk with your doctor. They may suggest other causes of hair loss and ways to manage them.
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How To Use Tysabri Vial
Read the Medication Guide provided by your pharmacist before you start using natalizumab and each time you receive another dose. If you have any questions, ask your doctor or pharmacist.
This medication is given by a health care professional in an infusion center as directed by your doctor, usually every 4 weeks. This medication is usually given over 1 hour. You will be monitored for 1 hour after your treatment is finished to make sure you do not have a serious reaction to the medication.
It is important to use this medication regularly to get the most benefit from it. Do not miss any doses without your doctor’s approval.
Tell your doctor if your condition worsens. When using this medication for Crohn’s disease, if your condition does not improve after 12 weeks of treatment, your doctor will need to switch your treatment plan.
Will I Have Withdrawal Symptoms If I Stop My Tysabri Treatment
Stopping Tysabri isnt expected to cause withdrawal symptoms.
But stopping Tysabri may cause symptoms of your condition to return or worsen. For this reason, its important to talk with your doctor if youre interested in stopping your Tysabri treatment. Your doctor can discuss other treatment options for your condition.
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Is Alopecia Areata Curable
It cannot be cured however, its possible to regrow hair. For some people, regrowth will happen without any help. Because alopecia areata cannot be cured, people who have regrowth can have more hair loss later. Some people have cycles of hair loss and regrowth.
If your hair doesnt regrow on its own, medical treatments may help.
There are many treatments for alopecia areata, and scientists are studying new possibilities. To see the treatment options, go to Alopecia areata: Diagnosis and treatment.
ReferencesKorta DZ, Christiano AM, et al. Alopecia areata is a medical disease. J Am Acad Dermatol. 2018 78:832-4.
Lakhmiri M, Cavelier-Balloy B, et al. Nivolumab-induced alopecia areata: A reversible factor of good prognosis? JAAD Case Reports. 2018 4:761-5.
Lee S, Lee H, et al. Comorbidities in alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol. 2019 80:466-77.
Paus R, Olsen EA, et al. Hair growth disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:764.
Strazzulla LC, Wang EHC, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018 78:1-12.
Thompson JM, Park MK, et al. Race and alopecia areata amongst US women. J of Investigative Dermatology Symposium proceedings. J Investig Dermatol Symp Proc. 2018 19:S47-S50.
Depression And Suicidal Thoughts And Behaviors
Tysabri may cause depression as a side effect in some people. In studies of the drug as a treatment for MS, depression was a common side effect.
Depression is also a common symptom of MS.
Very rarely, suicidal thoughts and actions were reported during studies of Tysabri for MS. These effects werent seen in the studies of the drug for Crohns disease.
Symptoms of depression may last for 2 weeks or longer and can include:
- feeling sad or hopeless
- loss of interest in your favorite activities
- changes in your usual appetite or sleep patterns
- lack of energy or motivation
What might help
If you already have depression, be sure to tell your doctor before starting Tysabri. They may monitor you more carefully than usual during Tysabri treatment to watch for signs of worsening depression.
If you notice depression symptoms as described above, talk with your doctor. They may recommend a treatment plan to ease depression.
It may also be helpful to see a mental health expert, such as a psychologist or therapist. They can offer strategies to help manage the stresses of your condition.
Its important to tell your doctor right away if you or someone close to you notices changes in your behavior or mood. If you have any thoughts of harming yourself, seek emergency medical care.
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Who Can Take Cladribine
You can take cladribine if:
- you have highly active relapsing MS. This means youve had two or more disabling relapses in the past year and MRI scans show you have more, or bigger, lesions. Guidelines call this rapidly evolving severe relapsing remitting MS
- despite taking a DMT, youve had a relapse in the past year and new or bigger lesions can be seen on your MRI scans
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Deliver And Refine Trials
The Phase 1 DELIVER study and the Phase 2 REFINE trial both compared two different formulations of Tysabri: intravenous and subcutaneous. A total of 366 people with RRMS or SPMS were involved in the two trials. The two formulations were similar in their effectiveness, safety, and pharmacological properties, the results broadly highlighted.
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Surprising Symptoms Of Multiple Sclerosis
Many people with MS experience fatigue and mobility issues, but there are other, less common symptoms.
When you have multiple sclerosis , damage to the nerve fibers in the central nervous system causes the signals between your brain, spinal cord, and the rest of your body go awry, according to the National Multiple Sclerosis Society . This interference in the transmission of nerve signals is what causes the symptoms of MS.
While symptoms vary greatly from person to person, and can get better or worse over time, more common symptoms include fatigue, walking difficulties, numbness or tingling, spasticity, weakness, vision problems, dizziness, bladder and bowel problems, sexual problems, pain, cognitive and emotional changes, and depression, per the NMSS.
However, there are also some less common symptoms of MS.
Whats surprising about MS symptoms is that they can affect so many different functions that people rely on every day in their lives, says Rosalind Kalb, PhD, vice president of the Professional Resource Center at the NMSS. Some are physical, some emotional, and some intellectual. We tend to focus on the ones we can all see, but many people may be living with a variety of symptoms that just arent apparent.
Here are some of the less common, more surprising symptoms that you might not be aware of.
Does Tecfidera Cause Weight Gain
Weight gain wasnt a side effect reported in studies of Tecfidera. But weight changes can be a symptom of multiple sclerosis , which Tecfidera treats.
Other drugs used to treat MS are known to have weight gain as a side effect. For example, corticosteroids may cause weight gain. Rayos is an example of a corticosteroid used to treat MS.
If youre concerned about weight gain while using Tecfidera, talk with your doctor. They can suggest ways to reach or maintain a suitable weight.
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Compliance With Ethics Guidelines
Informed consent was obtained from all individual participants included in the study. Additional written informed consent was obtained from participants for release of their images.
This trial was not registered on ClinicalTrials.gov because it is a real-world observational evaluation and not a clinical trial.
Alopecia Universalis Following Alemtuzumab Treatment In Multiple Sclerosis: A Barely Recognized Manifestation Of Secondary Autoimmunityreport Of A Case And Review Of The Literature
- 1Department of Neurology, Universitätsklinikum Bonn, Bonn, Germany
- 2Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
Secondary autoimmunity is the most frequent adverse event occurring in almost every other alemtuzumab-treated multiple sclerosis patient. We report a case of a patient with relapsing-remitting multiple sclerosis who reported smooth, circular areas of complete hair loss on both thighs 6 months after the second treatment cycle with alemtuzumab. The patient was diagnosed as having alopecia areata . Within 3 months, AA progressed to complete loss of all body hair . Current literature rarely connects alemtuzumab with the onset of alopecia of autoimmune origin. Here, we report a little-noticed autoimmune disease affecting the skin, very likely being associated with alemtuzumab. We emphasize the necessity of careful clinical surveillance of alemtuzumab-treated patients for yet undescribed autoimmune diseases.
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Treatments Given By Self
The first three long-term treatments for multiple sclerosis became available in the early to mid 1990s and were dubbed the A-B-C drugs because of their brand names: Avonex®, Betaseron®, and Copaxone®. These are interferon beta-1a, interferon beta-1b, and glatiramer acetate, respectively. In 2002, the United States Food and Drug Administration approved another interferon, Rebif® , for the long-term treatments of MS. This is the same drug as Avonex, but is injected differently and in more frequent and higher doses. In 2009, Extavia® was also approved. This is the same medicinal product as Betaseron and is given in the same doses, but is marketed under a different brand name and by a different pharmaceutical company.
In 2014, Plegridy® became the 11th DMT approved for the long-term treatment of relapsing forms of multiple sclerosis and the fifth interferon medication approved for MS. Plegridy is a pegylated version of interferon beta-1a. Pegylation is a chemical modification of a molecule that extends its half-life, which refers to how long a drug stays active in the body before it is metabolized or eliminated.
All eight of these self-injected disease-modifying therapies listed above are approved by the FDA for treating either relapsing-remitting MS or all relapsing forms of MS. Some of these DMTs have also been approved for clinically isolated syndrome , which refers to the initial symptom a patient reports prior to a diagnosis of MS.
Psychological Aspects Of Ms
Mood issues can be very common in MS, not just around the time of diagnosis, but at various stages of life. The most common mood disturbances are depression and anxiety which can be short or long term.
The most important thing to remember is to talk to your MS healthcare team as soon as you start to notice symptoms, so that you can access appropriate help, to improve your quality of life.
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Pregnancy And Breastfeeding While Receiving Tysabri Treatment
Its not known whether its safe to take Tysabri while pregnant. The medication hasnt been studied during pregnancy. However, there have been reports of side effects, such as low red blood cell levels, in newborns who were exposed to the drug before birth.
If youre pregnant or planning to become pregnant, talk with your doctor. Theyll advise you on the risks and benefits of receiving Tysabri treatment during pregnancy.
Tysabri is known to pass into breast milk. However, its not known whether this causes problems with breastfeeding or side effects in a child who is breastfed. Talk with your doctor about the risks and benefits and other possible feeding options for your child.
What Else Should I Tell My Healthcare Provider
Before receiving TYSABRI, it is important to tell your healthcare provider:
- If you have a medical condition that can weaken your immune system, such as:
- HIV infection or AIDS
- leukemia or lymphoma
- organ transplant
You may be treated with TYSABRI for as long as you and your healthcare team decide it is right for you. In the US, more than 40% of people being treated with TYSABRI have been using it for more than 5 years.
*Of the 20,816 patients taking TYSABRI, 12,646 have been treated with TYSABRI for > 5 years as of December 2020. TYSABRI was studied in a 2-year clinical trial and your risk of developing PML can increase over time. Talk to your healthcare provider to ensure the benefits continue to outweigh the risks.
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Will Tysabri Affect My Menstrual Cycle
Its possible. During studies of the drug, some people had menstrual cycle changes with Tysabri treatment.
Menstrual cycle changes with Tysabri may include painful periods, missed periods, or irregular cycles.
If menstrual cycle changes become bothersome or dont go away, talk with your doctor. Theyll be able to suggest ways to manage your symptoms.
Learn more about some of the side effects Tysabri may cause.