Quantitative assessment of CSF oligoclonal bands count as a biomarker of therapeutic response to Cladribine in multiple sclerosis

Abstract

Background. Reliable biomarkers are essential for monitoring treatment response and personalizing care in multiple sclerosis. This review presents data suggesting that Cladribine may influence cerebrospinal fluid (CSF) oligoclonal band count (OCB), supporting the potential use of OCBs as a marker of therapeutic efficacy. Objective(s). This study aims to investigate the correlation between cerebrospinal fluid oligoclonal band (OCB) levels and the duration of Cladribine therapy in patients diagnosed with multiple sclerosis (MS). Materials and methods. A systematic search of PubMed, Embase, Cochrane Library, Research Gate, and Scopus was conducted to identify studies published between 1994 and 2024. The research included terms such as "Multiple Sclerosis," "Oligoclonal band," and "Cladribine,". From A total of 440 Results. s, only (RCT's and cohort studies) five relevant sources were identified. Results. Across five selected studies, including cohort designs and randomized controlled trials, Cladribine treatment was consistently associated with reduced cerebrospinal fluid oligoclonal bands (OCBs). Sipe et al. (1994) reported a decline in mean OCB intensity from 29.9 (SD ±4.2) to 25.0 (SD ±3.3) after 6 months. Allen-Philbey et al. (2024) observed full OCB conversion in 40% of treated patients vs.18.2% in placebo. Single-arm studies showed similar trends; Rejdak et al. (2019) reported 55.2% conversion at 10 years, while Naismith et al. (2024) and Nicola De Stefano et al. (2024) analysis noted progressive reductions in OCB concentrations. Conclusion(s). This review suggests a correlation between CSF oligoclonal band count and Cladribine treatment duration in MS. Despite heterogeneity, limited data, and small sample sizes, the findings support the need for further research into biomarkers for monitoring response to Cladribine.