February 2026
Reading: Another School Day
09/02/26 22:59
Been doing some more reading on Cladribine/Mavenclad. And very interesting it was too. The drug was actually initially developed in injectable form for treatment of a form of leukaemia. It works by targeting type B and T lymphocytes (part of the white blood cell battle crew within each of us). It doesn’t ‘appear’ to damage other cells. It is thought that the B & T cells are then rebuilt in our body in a way that they no longer attack the myelin coating on nerve cells.
Reading about the treatment, it sounds a) largely positive, and b) like there’s a surprising amount of supposition on how it works. Drug development does seem to be through a hell of a lot of trial and error, and I guess if something works you don’t need to know why it does (even if that would be nice). You just need to know that it works and hopefully doesn’t cause bigger issues than it solves.
When it went up for approval originally in 2010 it didn’t get it due to there being more patients getting cancer than those in the placebo group. Apparently this was revisited and it seems that the numbers in the placebo group were statistically unusually low i.e. lower than just the national average. When they compared the results of the treatment group to the national average there was in fact no increased cancer risks (apparently). Statistics do need to be understood and challenged in a variety of ways, don’t they?
With the marketing of the drug only permitted since 2017 there can’t be any studies of the long term effects. But so far there haven’t been any significant concerns raised. Side effects can be; a decrease in white blood cells (lymphopenia), herpes virus infections (shingles, cold sores etc), hair loss, and rashes. Most my mates are follically challenged and I guess hair loss wouldn’t be the end of the world—and I’d to save money on haircuts too (though I’d rather not; fingers crossed). Whilst the long term effects are not known, the medium term effects are judged to be less serious than those of similarly effective MS drugs like Alemtuzumab, and Natalizumab (and having done a little more reading jeez the potential side effects of those drugs are indeed a lot more serious).
Cladribine is also not recommended for anyone wanting to start a family. I’m not currently, so that’s okay. For now.
Reading about the treatment, it sounds a) largely positive, and b) like there’s a surprising amount of supposition on how it works. Drug development does seem to be through a hell of a lot of trial and error, and I guess if something works you don’t need to know why it does (even if that would be nice). You just need to know that it works and hopefully doesn’t cause bigger issues than it solves.
When it went up for approval originally in 2010 it didn’t get it due to there being more patients getting cancer than those in the placebo group. Apparently this was revisited and it seems that the numbers in the placebo group were statistically unusually low i.e. lower than just the national average. When they compared the results of the treatment group to the national average there was in fact no increased cancer risks (apparently). Statistics do need to be understood and challenged in a variety of ways, don’t they?
With the marketing of the drug only permitted since 2017 there can’t be any studies of the long term effects. But so far there haven’t been any significant concerns raised. Side effects can be; a decrease in white blood cells (lymphopenia), herpes virus infections (shingles, cold sores etc), hair loss, and rashes. Most my mates are follically challenged and I guess hair loss wouldn’t be the end of the world—and I’d to save money on haircuts too (though I’d rather not; fingers crossed). Whilst the long term effects are not known, the medium term effects are judged to be less serious than those of similarly effective MS drugs like Alemtuzumab, and Natalizumab (and having done a little more reading jeez the potential side effects of those drugs are indeed a lot more serious).
Cladribine is also not recommended for anyone wanting to start a family. I’m not currently, so that’s okay. For now.
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