Вопросы контроля активности и безопасности при длительном наблюдении после применения кладрибина при рассеянном склерозе

Рассеянный склероз (РС) является хроническим заболеванием, в основе патогенеза которого лежат аутоиммунно-нейровоспалительные и нейродегенеративные компоненты. Целью терапии РС является снижение риска обострений и прогрессирования заболевания. В последние годы возможности терапии значительно расширились с учетом появления большего количества высокоэффективных препаратов, изменяющих течение РС (ПИТРС), а также в связи с разработкой нового направления – терапии иммунной реконституции (ТИР). ТИР имеет ряд преимуществ, среди которых короткие курсы при долгосрочном воздействии на иммунные механизмы. Таблетки кладрибина представляют собой селективную, высокоэффективную пероральную форму ТИР для пациентов с РС с обострениями, которая нацелена на лимфоциты, но при этом сохраняет клетки врожденного иммунитета. С учетом увеличения количества пациентов, получающих терапию кладрибином, возникает все больше вопросов о дальнейшей тактике ведения таких больных, особенно в случаях сохранения активности заболевания несмотря на проводимую патогенетическую терапию. В этом обзоре мы публикуем результаты консенсусных мнений международных экспертов по анализу длительного опыта применения кладрибина.

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