Neuromyelitis optica (NMO) is inflammatory disease affecting the CNS with severe consequences. NMO is a difficult to treat condition and new therapeutic options are need to provide effective and safe drugs acceptable for patients. Cladribine is an interesting compound selectively depleting both lymphocytes B and T leading to long-lasting immune reconstitution.

This was retrospective study. We reviewed medical records of all patients with NMO (2006 diagnostic criteria) who were treated with cladribine (CLAD) (2013 –2018).

Treatments

All patients were assessed regarding previous and concomitant treatments. The doses of other drugs had to be stable over at least 3 months before inclusion to the study. In the total group of patients 7 subjects received stable doses of prednisone before entry to the study.

Eleven AQP4 Ab positive patients were enrolled into the study: 7 females and 4 males and were qualified to the CLAD treatment.

None of the patients developed any signs or symptoms of toxicity. Average annualized relapse rate in the entire group comparing 24 months prior (1,0±0,4) versus 24 months after cladribine treatment initiation (0,23±0,3) was significantly reduced (p = .002). EDSS score did not significantly change over follow-up period (2,3±1,3; mean±SD) compared to baseline (2,2±1,5).

Four patients improved on the EDSS, two remained stable while four deteriorated after relapse (with partial recovery).

Caldribine treatment was safe in NMO patients over 2 year observation.

Cladribine treatment was associated with clinical stabilization, as evidenced by significantly decreased annualized relapse rate, and protected patients from progression on EDSS.