Multiple Sclerosis Center, IRCCS San Raffaele Hospital, Milan, Italy/Neurology Department, IRCCS San Raffaele Hospital, Milan, Italy.
Department of Biomedical and Clinical Sciences \'L.Sacco\' University of Milan, Milan, Italy.
Curr Neuropharmacol. 2022;20(10):1811-1815. doi: 10.2174/1570159X20666211217160451.
COVID 19 pandemic and mass vaccination campaigns have revealed the situation of the most vulnerable patients. In this work, we focused our attention to patients who have Multiple Sclerosis (MS), particularly in treatment with cladribine tablets, trying to understand if and when it is possible to administer the vaccine successfully. In light of the novel topic, we studied the existing literature and analysed experiences with previous vaccinations, such as influenza and VZV, as well as data from countries where vaccination campaigns had already begun. Overall, we have taken into account the mechanism of action, the pharmacokinetic/pharmacodynamic of cladribine, and the changes in the immune system after its administration, together with the preliminary data about the humoral response to influenza, VZV, and SARS-CoV-2 vaccinations in cladribine treated patients. In conclusion, data showed that the use of cladribine tablets seems to permit flexibility regarding vaccination timing and we suggest that vaccination in those patients should be safe and effective. The current COVID 19 pandemic has re-ignited the interest in vaccines and vaccination procedures. The importance of including fragile individuals has increased as a result of mass vaccination. Millions of patients with multiple sclerosis (MS) around the world are debating whether they can safely receive their vaccine shot with the same efficacy despite receiving immune-modulating or immune-suppressive treatments. In the absence of conclusive empirical data, we will review and discuss the available evidence and the reasonable conclusions for one specific treatment, namely cladribine tablets (Mavenclad).
COVID-19 大流行和大规模疫苗接种运动揭示了最脆弱患者的情况。在这项工作中，我们将注意力集中在患有多发性硬化症（MS）的患者身上，特别是在接受克拉屈滨片治疗的患者身上，试图了解是否有可能成功接种疫苗以及何时可以接种疫苗。鉴于这是一个新颖的主题，我们研究了现有文献，并分析了以前接种流感和 VZV 疫苗的经验，以及已经开始疫苗接种运动的国家的数据。总的来说，我们考虑了克拉屈滨的作用机制、药代动力学/药效学、以及给药后免疫系统的变化，同时考虑了克拉屈滨治疗患者对流感、VZV 和 SARS-CoV-2 疫苗接种的体液反应的初步数据。总之，数据表明，使用克拉屈滨片似乎可以灵活安排接种时间，我们建议对这些患者进行疫苗接种应该是安全有效的。当前的 COVID-19 大流行重新引发了人们对疫苗和接种程序的兴趣。由于大规模接种，脆弱个体的重要性增加了。全球数以百万计的多发性硬化症（MS）患者正在争论他们是否可以在接受免疫调节或免疫抑制治疗的情况下安全地接种与普通人群相同的疫苗。在缺乏确凿的经验数据的情况下，我们将回顾和讨论现有证据以及针对一种特定治疗方法（即克拉屈滨片）的合理结论。
