Summary of Cladribine (from Development to Clinical and Practical Treatment)

Multiple sclerosis (MS) is a chronic inflammatory central nervous system disorder involving autoreactive T and B cells, causing demyelination and axonal damage. Cladribine (Mavenclad®, Merck, Rahway, NJ, USA), an oral disease-modifying therapy for relapsing-remitting MS, offers a short, simplified dosing schedule. Acting on CD4+, CD8+, and CD19+ cells, it reduces disease activity and relapse rates, as demonstrated in the CLARITY study, with a 57.6% reduction in annual relapse rate. Despite concerns about lymphopenia, immune recovery occurs over time. Real-world data (GLIMPSE) confirm efficacy comparable to other therapies. Early, high-efficacy treatment is crucial, necessitating policy changes to improve patient access to diverse therapies.