Mavenclad (cladribine) vs Mayzent (Siponimod)

Mavenclad (cladribine) is an oral medication specifically approved for the treatment of relapsing forms of multiple sclerosis (MS), including relapsing-remitting disease and active secondary progressive disease, in adults. It works by selectively reducing certain types of white blood cells that are thought to be involved in the pathological process of MS. In contrast, Mayzent (siponimod) is also used to treat relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, but it functions by modulating specific types of immune system receptors called sphingosine-1-phosphate (S1P) receptors, which are involved in the movement of lymphocytes in and out of the central nervous system. The choice between Mavenclad and Mayzent should be made in consultation with a healthcare provider, considering factors such as the individual's disease characteristics, treatment history, potential side effects, and monitoring requirements.

Difference between Mavenclad and Mayzent

Metric	Mavenclad (cladribine)	Mayzent (Siponimod)
Generic name	Cladribine	Siponimod
Indications	Multiple sclerosis (MS), specifically relapsing-remitting disease and active secondary progressive disease	Relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease
Mechanism of action	Immunosuppressive agent; induces long-lasting reduction in T and B lymphocyte counts	Sphingosine 1-phosphate receptor modulator; traps lymphocytes in lymph nodes, reducing their migration to the central nervous system
Brand names	Mavenclad	Mayzent
Administrative route	Oral	Oral
Side effects	Lymphopenia, leukopenia, infection, liver enzyme elevations, hematological abnormalities	Headache, hypertension, liver enzyme elevations, macular edema, bradyarrhythmia
Contraindications	HIV infection, active chronic infections, hypersensitivity to cladribine	Cardiovascular conditions that would preclude the use of immunosuppressive drugs, untreated severe breathing problems, liver disease, hypersensitivity to siponimod
Drug class	Antimetabolite, purine analog	Sphingosine 1-phosphate receptor modulator
Manufacturer	Merck	Novartis

Efficacy

Mavenclad (Cladribine) Efficacy in Multiple Sclerosis

Mavenclad, known generically as cladribine, is an oral medication approved for the treatment of relapsing forms of multiple sclerosis (MS), including relapsing-remitting disease and active secondary progressive disease, in adults. Clinical trials have demonstrated the efficacy of Mavenclad in reducing the rate of relapses and slowing the progression of disability in individuals with MS. The CLARITY study, a key phase III clinical trial, showed that treatment with Mavenclad resulted in a significant reduction in annualized relapse rates compared to placebo. Additionally, MRI findings from the same study indicated that cladribine reduced the number of lesions and the progression of disease activity.

The mechanism of action of Mavenclad involves the selective targeting and reduction of B and T lymphocytes, which are believed to be involved in the pathological process of MS. By inducing a transient and dose-dependent reduction in these immune cells, Mavenclad modulates the immune response and helps to prevent relapses and new lesions. The therapeutic effects of Mavenclad are long-lasting, allowing for a dosing schedule that involves taking the medication for only a few days per year over two years.

Mayzent (Siponimod) Efficacy in Multiple Sclerosis

Mayzent, or siponimod, is another oral medication approved for the treatment of relapsing forms of multiple sclerosis, which includes clinically isolated syndrome, relapsing-remitting MS, and active secondary progressive MS. The efficacy of Mayzent was established through the EXPAND trial, a phase III study, which showed that siponimod significantly reduced the risk of three-month confirmed disability progression compared to placebo. It also demonstrated a reduction in annualized relapse rates and a favorable impact on MRI lesion activity.

Mayzent works by modulating the sphingosine-1-phosphate (S1P) receptor, which is involved in the migration of lymphocytes out of lymph nodes, thereby reducing the number of lymphocytes available to cause central nervous system inflammation. This mechanism of action helps to manage the autoimmune response associated with MS. Mayzent has the advantage of being selective for certain subtypes of the S1P receptor, potentially offering a favorable safety profile. The treatment is tailored to the patient's needs, with the dose titrated at the start of therapy to mitigate cardiac effects associated with the initiation of S1P receptor modulators.

Regulatory Agency Approvals

Mavenclad

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Mayzent

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Therapeutic Goods Administration (TGA), Australia

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