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Leist, T.P., Comi, G., Cree, B.A., Coyle, P.K., Freedman, M.S., Hartung, H.P., Vermersch, P., Casset-Semanaz, F. and Scaramozza, M. (2014) Effect of Oral Cladribine on Time to Conversion to Clinically Definite Multiple Sclerosis in Patients with a First Demyelinating Event (ORACLE MS): A Phase 3 Randomized Trial. The Lancet Neurology, 13, 257-267.
https://doi.org/10.1016/S1474-4422(14)70005-5

has been cited by the following article:

• TITLE: Pharmacokinetic Study and Toxicity of Leukovir: A New Combined Drug for the Treatment of Multiple Sclerosis

  AUTHORS: Elena N. Kalinichenko, Irina V. Ponteleeva, Marina B. Golubeva

  KEYWORDS: Leukovir, Cladribine, Ribavirin, Multiple Sclerosis, Pharmacokinetics, Toxicity

  JOURNAL NAME: Advances in Biological Chemistry, Vol.12 No.1, January 21, 2022

  ABSTRACT: Leukovir, an enteric-coated tablet, is the original drug product for internal use. The well-known nucleosides cladribine and ribavirin are the active ingredients of the drug product leukovir. Pharmacokinetic parameters of the drug product for the internal use of leukovir active ingredients have been established. The cladribine half-absorption period was t1/2a = 49.5 h, C0 = 276.4 μg/ml, Cmax = 6.0 μg/ml. Distribution and accumulation parameters (Vd, Vss and AUC) have indicated that the drug distribution between the blood cells and blood plasma takes place in the same way, irrespective of the dosage form. Cladribine half-life period is t1/2e = 0.62 hours. The molecule total clearance and average lifetime in the body in the case of subcutaneous drug administration are approximately the same. Ribavirin is characterized by a half-absorption period of t1/2a = 0.71 h, C0 = 115.6 μg/ml and Cmax = 75.5 μg/ml. Ribavirin total volume of distribution (Vd = 1.3 l/kg) and stationary volume of distribution (Vss = 1.64 l/kg) were practically similar to leukovir when administered subcutaneously. The AUC value = 504.2 μg h/ml, which is 2.5 times less than that in the case of drug form administration. Leukovir was regarded as slightly toxic in an acute toxicity study. The risk of cumulation for this drug product is low.