Tortorella C, Rovaris M, Filippi M
Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Curr Opin Investig Drugs. 2001 Dec;2(12):1751-6.
Cladribine, an adenosine deaminase inhibitor, has been developed and launched by Ortho Biotech in collaboration with The Scripps Research Institute for the treatment of several neoplasms, including acute myelogenous leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, cutaneos T-cell lymphoma, hairy-cell leukemia and non-Hodgkin's lymphoma. It was first launched in the US in February 1993. Ortho Biotech and The Scripps Research Institute have since been developing the compound for its potential use in multiple sclerosis (MS). In 1997, Ortho filed air NDA in the US for the use of cladribine in the treatment of relapsing-remitting and secondary progressive MS. An FDA drug advisory committee was planning to meet in January 1999 to discuss the NDA. However, Ortho cancelled the meeting. Following an FDA inspection during December 1998 and January 1999, the Scripps Clinic received a warning letter from the FDA in April 1999 regarding violations in the clinical studies of cladribine for MS, and Ortho withdrew the NDA after concluding that further clinical studies would be necessary. Cladribine has been known since the 1960s as an intermediate for the synthesis of 2-deoxynucleotides and its potential for the treatment of leukemia was disclosed in 1984. The Scripps Research Institute and the Johnson & Johnson group hold several patents claiming preparation methods (US 05208327), and additional indications, such as multiple sclerosis (WO-09316706) and rheumatoid arthritis (US-05310732). The associated patent, WO-09323508, is the only one among those patents that claims the use of unmodified cladribine for the treatment of leukemia, but it focuses particularly on a specific form of the disease, chronic myelogenous leukemia. Analysts at UBS Warburg predicted in October 2001, that the product would make US sales of $50 million in 2004 for its MS indication.
克拉屈滨是一种腺苷脱氨酶抑制剂,由奥索生物技术公司(Ortho Biotech)与斯克里普斯研究所合作开发并推出,用于治疗多种肿瘤,包括急性髓性白血病、慢性淋巴细胞白血病、慢性髓性白血病、皮肤T细胞淋巴瘤、毛细胞白血病和非霍奇金淋巴瘤。它于1993年2月在美国首次推出。此后,奥索生物技术公司和斯克里普斯研究所一直在开发该化合物,以探索其在多发性硬化症(MS)中的潜在用途。1997年,奥索公司向美国提交了一份新药申请(NDA),申请将克拉屈滨用于治疗复发缓解型和继发进展型多发性硬化症。美国食品药品监督管理局(FDA)的一个药物咨询委员会原计划在1999年1月开会讨论该新药申请。然而,奥索公司取消了这次会议。在1998年12月至1999年1月的一次FDA检查后,斯克里普斯诊所于1999年4月收到了FDA发出的一封警告信,信中指出在克拉屈滨用于多发性硬化症的临床研究中存在违规行为,奥索公司在得出需要进一步进行临床研究的结论后撤回了新药申请。自20世纪60年代以来,克拉屈滨就作为合成2-脱氧核苷酸的中间体为人所知,其治疗白血病的潜力于1984年被披露。斯克里普斯研究所和强生集团拥有多项专利,涵盖制备方法(美国专利05208327)以及其他适应症,如多发性硬化症(国际专利申请WO-09316706)和类风湿性关节炎(美国专利05310732)。相关专利WO-09323508是这些专利中唯一一项主张使用未修饰的克拉屈滨治疗白血病的专利,但它特别关注该疾病的一种特定形式,即慢性髓性白血病。瑞银华宝(UBS Warburg)的分析师在2001年10月预测,该产品用于多发性硬化症适应症在2004年的美国销售额将达到5000万美元。