Thomas Leist, MD: Immune Reconstitution Therapy for Multiple Sclerosis

“The whole concept behind these treatments is that we try to reset the immune system in multiple sclerosis in a direction of a non-self-aggressive, non-self-reactive immune system.”

Recently, there has been a move toward the development of immune reconstitution therapies for multiple sclerosis (MS). These therapies, administered in short treatment courses, reduce immune cells in order to essentially reset the immune system to a non-self-reactive state. Two notable examples are alemtuzumab and cladribine.

Although not approved in the United States, Thomas Leist, MD, has worked closely with cladribine in its clinical development through the ORACLE and CLARITY trials. In ORACLE, patients with clinically isolated syndrome (CIS), the first event toward a diagnosis of MS, were given the oral therapy with very positive results in reducing the risk of patients advancing to clinically definite MS. Despite an observed slightly increased oncologic risk, this was not observed in subsequential trials.

At the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany, the professor of neurology and director of the Comprehensive Multiple Sclerosis Center at Thomas Jefferson University sat with NeurologyLive to share his experience with cladribine and with this class of medications.