What are the risks of switching to Mavenclad?

Question

Hello doctor,

I have been on Gilenya for 8 months, and my recent blood work is concerning. My lymphocyte count dropped to 0.1, and elevated liver enzymes have now been detected. My neurologist is recommending a switch to Mavenclad, but I have read worrisome things about bone marrow suppression with this medication. What are the risks of switching, and how long will it take for my immune system to recover? Would you like help understanding these risks or exploring other treatment options?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Mavenclad (Cladribine) is a disease-modifying therapy (DMT) for active multiple sclerosis (MS), designed to slow disease progression and reduce relapse rates. By targeting destructive immune cells, it selectively accumulates inside these cells, programming them for cell death. This action helps reduce brain and spinal cord inflammation, thereby limiting damage. Studies indicate that 80 percent of treated patients show no evidence of disease activity in year four of treatment, highlighting its long-term effectiveness. Additionally, Mavenclad reduces the effectiveness of T cells during inflammation, further protecting the brain and spinal cord.

Switching from Gilenya (fingolimod) to Mavenclad may shorten relapses and improve outcomes, but it’s important to consider potential risks like bone marrow suppression. While this side effect can occur with long-term use, controlled low doses are less likely to affect bone health significantly. Close monitoring, especially during the first four to eight weeks of treatment, is essential to ensure safety and manage hematologic findings. Compared to other MS treatments, Mavenclad has an average patient rating of 9.7 out of 10, higher than Gilenya's 7.1, indicating higher satisfaction and effectiveness in many cases. Try to wash your hands regularly and wear masks to protect your body.

I hope this helps you.

Thank you.