Real-world performance of cladribine in multiple sclerosis: a single centre study

<h3>Introduction</h3> Cladribine is recommended in RRMS by NHSE. We set out to map the real-world performance of cladribine at our tertiary MS centre. <h3>Methods</h3> Retrospective notes review. <h3>Results</h3> We treated 35 patients (60% female), median age 39 years (range 22–65) and a median EDSS of 2 (range 1.0–6.0); Ten (29%) were new starters (with RES- MS as per NHSE) and 25 (71%) were switchers (24 with new activity; 1 due to intolerance). Median follow up was 26 months (range 3–67 months). Eighteen (51%) completed 2 years of whom 15 (83%) remain stable at latest follow up. Three (17%) changed treatments within four years (natalizumab [1] and ocrelizumab [2]). Eleven (31%) required alternative treatment within the first year, 9 (26% of total) due to disease activity and 2 (6% of total) due to side effects (GI upset [1], hair loss [1]). Of the 9 patients with new relapse activity, three were new starters and six were switchers. Median EDSS at latest follow up remained 2. <h3>Conclusion</h3> In this single centre case series, cladribine, predominantly used as an escalation treatment, was generally well tolerated but failed to suppress MS activity requiring treatment change in one out of three patients within the first year.