{"id":37264,"date":"2022-11-16T11:47:25","date_gmt":"2022-11-16T11:47:25","guid":{"rendered":"https:\/\/touchneurology.com\/?p=37264"},"modified":"2023-04-27T11:42:00","modified_gmt":"2023-04-27T10:42:00","slug":"cladribine-tablets-a-review-of-the-practical-considerations-in-multiple-sclerosis-nursing-practice","status":"publish","type":"post","link":"https:\/\/touchneurology.com\/multiple-sclerosis\/journal-articles\/cladribine-tablets-a-review-of-the-practical-considerations-in-multiple-sclerosis-nursing-practice\/","title":{"rendered":"Cladribine Tablets: A Review of the Practical Considerations in Multiple Sclerosis Nursing Practice"},"content":{"rendered":"
Disease-modifying therapies (DMTs) have brought about substantial improvements to the lives of people with multiple sclerosis (MS).1\u20133<\/span>\u00a0However, MS remains a chronic disease with a variable course and symptoms, representing a substantial challenge to quality of life.2,3<\/span>\u00a0MS management requires a personalized approach by which healthcare professionals (HCPs) partner with patients.4,5<\/span>\u00a0MS nurses play a central role in MS management and are uniquely positioned to create and maintain these partnerships.4,5<\/span>\u00a0Through individualized communication, MS nurses can help patients understand their condition and treatment while supporting lifestyle choices and encouraging medication adherence.4,5<\/span><\/p>\n This update summarizes the clinical profile of cladribine tablets in MS and provides a review of practical considerations for nursing care for people with MS who are receiving cladribine tablets, which are topics that have not been explored sufficiently in the literature. Published articles were selected by the authors based on their relevance to the topics included. The author team, consisting of physicians and nurses, agreed on key communication points and developed the example questions (see text boxes) based on their clinical experience to assist HCPs involved in the care of patients with MS.<\/p>\n MS is characterized by immune cells attacking the myelin sheath surrounding nerve cells, resulting in inflammation and destruction of the nerve cells within the central nervous system.2,3<\/span>\u00a0Inflammation and neurodegeneration are present throughout the course of MS, with inflammation causing relapses and the accumulation of new magnetic resonance imaging (MRI) lesions most prominent early in the disease.1\u20133<\/span>\u00a0As a result, immunomodulating therapies for MS mainly target inflammation and are most effective early in the disease course.2<\/span>\u00a0Current therapies can be divided into continuous (also called maintenance therapies, which exert efficacy while they are administered) and intermittent (sometimes called immune reconstitution therapies).6<\/span>\u00a0Immune reconstitution therapies are given as short courses and can yield longer-lasting efficacy beyond the administration period.6\u201312<\/span>\u00a0The therapy causes transient reductions in certain types of lymphocytes (Supplemental Digital Content 1<\/span>\u00a0and<\/span>\u00a02<\/span><\/em><\/a>),6\u20138<\/span>\u00a0which return to within normal limits during the subsequent months.6\u20138<\/span>\u00a0Clinical data indicate that treatment with cladribine tablets results in durable clinical responses and a favourable risk\u2013benefit ratio.9\u201311<\/span><\/p>\n Cladribine tablets are indicated for adults with highly active relapsing MS in the EU and Australia.7<\/span>\u00a0They are taken orally at home for up to 10\u00a0days per year for 2 years only; further cladribine tablets treatment is not recommended in years 3 and 4 (Supplemental Digital Content 1<\/span><\/em><\/a>).7<\/span>\u00a0This dosing pattern reflects the long-term effects of a short course of cladribine tablets in people with MS.6<\/span>\u00a0Specialist MS nurses have a key role to play in explaining this dosing and providing reassurance on efficacy and safety.4,5<\/span><\/p>\nPurpose and methods<\/h1>\n
Management of multiple sclerosis<\/h1>\n
Nursing considerations for patients prescribed cladribine tablets<\/h1>\n