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Paid for by EMD Serono
‘YOU JUST HAVE TO BE PREPARED’: AN EMERGENCY ROOM NURSE TALKS LIFE WITH
RELAPSING MS
Eleisha doesn’t let RMS stop her from enjoying the beauty of nature. (Photo
courtesy of Eleisha)Growing up in Missouri, Eleisha spent much of her childhood
outdoors. Her parents and grandparents would often take her hiking in Elephant
Rocks State Park, where a string of ancient pink boulders stand trunk-to-tail
like a parade of circus elephants.
She logged miles on her boots trekking around the American Southwest and
exploring the forests of Ireland.
“I tell my dad, I just need dirt and grass,” Eleisha says. “I just need to get
outside.”
That adventurous spirit — as well as a passion for helping others — led Eleisha
to pursue a career in critical care nursing. Eleisha and her brother both live
with RMS. (Photo courtesy of Eleisha)
Then one day, when she was in her 30s, Eleisha began experiencing numbness and
tingling in her left arm and index finger. And whenever she tilted her head
forward, nerve shocks would radiate down her spine. Her primary care doctor
suggested it might be due to a combination of carpal tunnel syndrome and spinal
nerve compression.
Years earlier, her brother had been diagnosed with relapsing multiple sclerosis
(RMS) after experiencing similar symptoms, so she decided to consult with his
neurologist. MRI scans confirmed that Eleisha had RMS as well.
Not one to take things lying down, Eleisha and her neurologist discussed
starting treatment right away. The medicine helped her RMS symptoms, but over
time the treatment was no longer working well for her. She was working the night
shift and would utterly collapse as soon as she got home.
Then, her doctor told her about MAVENCLAD® (cladribine) tablets, which consists
of 10 days of treatment per year over a two-year period. After discussing the
dosing and safety information with her doctor, Eleisha felt comfortable trying
MAVENCLAD.
MAVENCLAD is a prescription medicine used to treat relapsing forms of MS, to
include relapsing-remitting disease and active secondary progressive disease, in
adults. Because of its safety profile, MAVENCLAD is generally used in people who
have tried another MS medicine that they could not tolerate or that has not
worked well enough. MAVENCLAD is not recommended for use in people with
clinically isolated syndrome.
MAVENCLAD can cause serious side effects, including the risk of cancer
(malignancies) and risk of birth defects if used during pregnancy. Females must
not be pregnant when they start treatment with MAVENCLAD or become pregnant
during MAVENCLAD dosing and within six months after the last dose of each yearly
treatment course. Additional serious side effects can include low blood cell
counts and serious infections such as TB, hepatitis B or C, shingles or
progressive multifocal leukoencephalopathy, as well as liver problems, allergic
reactions and heart failure. The most common side effects of MAVENCLAD include
upper respiratory infection, headache and low white blood cell count.
Living with RMS has given Eleisha a unique perspective when working with
patients. (Photo courtesy of Eleisha)
Eleisha's doctor explained the potential serious side effects of MAVENCLAD,
including the risk of cancer and birth defects, as well as the possibility of
low white blood cell counts, serious infections and liver problems. Eleisha
began treatment with MAVENCLAD in 2019 after completing the initial screening
and education, including using effective contraception and the need for ongoing
monitoring and doctor visits.
RMS specialist Dr. Heidi Crayton encourages her patients to talk through their
hopes and concerns to make sure they end up with a treatment plan suits their
individual needs.
“In addition to what testing reveals, I need to know a patient and their
lifestyle when deciding what RMS medication to recommend,” Crayton says.
“There are good days and bad days with RMS. Just like there are smooth trails
and rocky ones,” Eleisha says. (Photo courtesy of Eleisha)
Shortly after switching to MAVENCLAD, Eleisha was thrust onto the frontlines of
the COVID-19 pandemic in her role as a critical care nurse. Fortunately,
MAVENCLAD has thus far been working well in managing Eleisha's symptoms. And the
convenience of taking oral tablets just 10 days a year over a two-year period
fit right in with her schedule.
However, each individual is different, and results may vary. It’s important for
patients to talk thoroughly with their health care provider about their symptoms
and treatment plan for the best possible outcome.
Eleisha still likes to spend her free time communing with nature, usually
paddling a kayak or lacing up her boots and exploring a new hiking trail, though
she says it’s important to be careful on very hot days because the heat can
exacerbate her RMS symptoms.
“There are good days and bad days with RMS. Just like there are smooth trails
and rocky ones,” Eleisha says. “But in both cases, you just have to be prepared.
You make sure that you have everything in place so the journey is as smooth as
possible.”
To hear stories from a diverse group of people about their experiences living
with RMS and how they’ve learned to express themselves with their loved ones,
the RMS community, their health care providers and the world,
visit Express4MS.com.
What is MAVENCLAD?
MAVENCLAD is a prescription medicine used to treat relapsing forms of multiple
sclerosis (MS), to include relapsing-remitting disease and active secondary
progressive disease, in adults. Because of its safety profile, MAVENCLAD is
generally used in people who have tried another MS medicine that they could not
tolerate or that has not worked well enough.
MAVENCLAD is not recommended for use in people with clinically isolated syndrome
(CIS).
It is not known if MAVENCLAD is safe and effective in children under 18 years of
age and is therefore not recommended.
MAVENCLAD may cause serious side effects, including:
* Risk of cancer (malignancies). You should follow healthcare provider
instructions about screening for cancer.
* MAVENCLAD may cause birth defects if used during pregnancy. Females must not
be pregnant when they start treatment with MAVENCLAD or become pregnant
during MAVENCLAD dosing and within 6 months after the last dose of each
yearly treatment course. You should stop treatment with MAVENCLAD and contact
your healthcare provider right away if you become pregnant during treatment
with MAVENCLAD.
1. For females who are able to become pregnant:
1. Your healthcare provider should order a pregnancy test before you begin
your first and second yearly treatment course of MAVENCLAD to make sure
that you are not pregnant.
2. Use effective birth control (contraception) on the days on which you
take MAVENCLAD and for at least 6 months after the last dose of each
yearly treatment course.
1. Talk to your healthcare provider if you use oral contraceptives (the
“pill”).
2. You should use a second method of birth control on the days on which
you take MAVENCLAD and for at least 4 weeks after your last dose of
each yearly treatment course.
2. For males with female partners who are able to become pregnant:
1. Use effective birth control (contraception) during the days on which
you take MAVENCLAD and for at least 6 months after the last dose of
each yearly treatment course.
Do not take MAVENCLAD if you:
* have cancer (malignancy).
* are pregnant, plan to become pregnant, or are a woman of childbearing age or
a man able to father a child and you are not using birth control.
* are breastfeeding.
* are human immunodeficiency virus (HIV) positive.
* have active infections, including tuberculosis (TB), hepatitis B or C.
* are allergic to cladribine.
Before you take MAVENCLAD, tell your healthcare provider about all of your
medical conditions, including if you:
* think you have an infection.
* have taken, take, or plan to take medicines that affect your immune system or
blood cells, or other treatments for MS. Certain medicines can increase your
risk of getting an infection.
* have had a recent vaccination or are scheduled to receive any vaccinations.
You should not receive live or live-attenuated vaccines within the 4 to 6
weeks preceding treatment with MAVENCLAD or receive these types of vaccines
during your treatment with MAVENCLAD and unless directed by your healthcare
provider.
* have heart failure.
* have or have had cancer.
* have liver or kidney problems.
* are breastfeeding or plan to breastfeed. It is not known if MAVENCLAD passes
into your breast milk. Do not breastfeed on the days on which you take
MAVENCLAD, and for 10 days after the last dose.
How should I take MAVENCLAD?
* MAVENCLAD is given as two yearly treatment courses.
* Each yearly treatment course consists of 2 treatment weeks (also called
cycles) that will be about a month apart.
* Take MAVENCLAD with water and swallow whole without chewing. MAVENCLAD can be
taken with or without food.
* Swallow MAVENCLAD right away after opening the blister pack.
* Your hands must be dry when handling MAVENCLAD and washed well with water
afterwards.
* Limit contact with your skin. Avoid touching your nose, eyes and other parts
of the body. If you get MAVENCLAD on your skin or on any surface, wash it
right away with water.
* Take MAVENCLAD at least 3 hours apart from other medicines taken by mouth
during the 4- to 5-day MAVENCLAD treatment week.
* If you miss a dose, take it as soon as you remember on the same day. If the
whole day passes before you remember, take your missed dose the next day. Do
not take 2 doses at the same time. Instead, you will extend the number of
days in that treatment week.
Your healthcare provider will continue to monitor your health during the 2
yearly treatment courses, and for at least another 2 years during which you do
not need to take MAVENCLAD. It is not known if MAVENCLAD is safe and effective
in people who restart MAVENCLAD treatment more than 2 years after completing 2
yearly treatment courses.
MAVENCLAD can cause serious side effects. If you have any of these symptoms
listed below, call your healthcare provider right away:
* low blood cell counts have happened and can increase your risk of infections
during treatment with MAVENCLAD. Blood tests are needed before you start
treatment with MAVENCLAD, during your treatment with MAVENCLAD, and
afterward, as needed.
* serious infections such as:
* TB, hepatitis B or C, and shingles (herpes zoster). Fatal cases of TB and
hepatitis have happened with cladribine during clinical studies. Tell your
healthcare provider right away if you get any symptoms of the following
infection related problems or if any of the symptoms get worse, including:
fever, aching painful muscles, headache, feeling of being generally unwell,
loss of appetite, burning, tingling, numbness or itchiness of the skin in
the affected area, skin blotches, blistered rash, or severe pain.
* progressive multifocal leukoencephalopathy (PML). PML is a rare brain
infection that usually leads to death or severe disability. Although PML
has not been seen in MS patients taking MAVENCLAD, it may happen in people
with weakened immune systems. Tell your healthcare provider right away if
you have any new or worsening neurologic signs or symptoms. These may
include: weakness on 1 side of your body, loss of coordination in your arms
and legs, decreased strength, problems with balance, changes in your
vision, changes in your thinking or memory, confusion, or changes in your
personality.
* liver problems. Blood tests should be performed to check your liver before
you start taking MAVENCLAD. Symptoms of liver problems may include: nausea,
vomiting, stomach pain, tiredness, loss of appetite, dark urine, or your skin
or the whites of your eyes turn yellow.
* allergic reactions (hypersensitivities). You should stop treatment and seek
immediate medical attention if any signs or symptoms of allergic reactions
occur. Symptoms of an allergic reaction may include: skin rash, swelling or
itching of the face, lips, tongue or throat, or trouble breathing.
* heart failure. MAVENCLAD may cause heart failure, which means your heart may
not pump as well as it should. Call your healthcare provider or go to the
closest emergency room for medical help right away if you have any signs or
symptoms such as shortness of breath, a fast or irregular heart beat, or
unusual swelling in your body.
The most common side effects of MAVENCLAD include: upper respiratory infection,
headache, and low white blood cell counts.
These are not all the possible side effects of MAVENCLAD. Call your doctor for
medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088.
Please see the full Prescribing Information/Medication Guide, including serious
side effects, for additional Important Safety Information.
This article was sponsored by EMD Serono, the Healthcare business of Merck KGaA,
Darmstadt, Germany in the U.S. and Canada.
MAVENCLAD is a registered trademark of Merck KGaA, Darmstadt, Germany or its
affiliates.
02/23 US-MAV-01903
Produced by AP Content Services, the paid content service of The Associated
Press. The AP news staff was not involved in the creation of this content.
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