Cladribine and teriflunomide in the UKMSR: a real world cohort evaluation

<h3>Background</h3> The UKMS Register (UKMSR) is a longitudinal disease register capturing clinical data from the NHS and outcomes from people with MS (pwMS) via the internet. Cladribine is a disease modifying therapy for pwMS with rapidly evolving relapsing disease. <h3>Aim</h3> To evaluate real world pwMS data on Cladiribine and compare it to Teriflunomide. <h3>Method</h3> Retrospective UKMSR cohort where pwMS had reported Cladribine (n=180) or Teriflunomide (n=255) use. Outcomes were the normalised Multiple Sclerosis Impact Scale (MSIS29-Phys) to assess disability, fatigue severity scale (FSS) and EuroQOL-5D3L for quality of life assessment. Timepoints were 2 years pre-prescription, at prescription, and 2 years post prescription. <h3>Results</h3> Cladribine cohort (mean age±SD) 44.1±10.7 was younger than Teriflunomide 52.0±9.9 with shorter disease duration 12.6±7.4 yrs vs 17.2±9.6. Gender balance was 70% female across both cohorts. MSIS29-Phys in Cladribine 2 years-Pre was 26.3±23.9, At Prescription 31.8±28.1 and 2 years post 28.0±26.9. Teriflunomide was pre: 30.0±21.9, at: 30.6±21.6, post: 30.2±21.8. This pattern was similar for FSS and EQ5D. <h3>Discussion</h3> We observed pwMS prescribed Cladribine at a younger age, and had worse disability at prescription. Two years post prescription they had returned to pre-prescription levels of disability. The Teriflunomide cohort showed no significant changes over 4 years.