Cladribine in tablets in real clinical practice: Results of treatment of 267 patients with multiple sclerosis in Moscow

Introduction. Over the past 30 years, there has been a dramatic change in approaches to the treatment of multiple sclerosis (MS), due to the development of a large number of drugs with different mechanisms of action for the disease-modifying treatment (DMT) of MS. Aim . To form, based on the analysis of the obtained data, an optimal algorithm for the management of patients with MS receiving cladribine tablets in the conditions of real clinical practice. Materials and methods . A retrospective analysis of the data obtained on the background of therapy with cladribine in MS patients at the end of 2024 was conducted on the basis of the Moscow inter-district departments of MS. The data from outpatient records of MS patients treated with cladribine from 2021 to 2023 were used as research material. Data collection was carried out on the initial clinical and demographic characteristics of patients, as well as indicators of the effectiveness of therapy (average annual frequency of exacerbations, activity according to MRI data and progression according to the EDSS scale) and the presence of adverse reactions against the background of therapy with cladribine. Results. This publication presents the experience of using the drug cladribine in real clinical practice in 267 MS patients in Moscow in the period from 2021 to 2023. Patients who underwent two full annual courses of therapy showed a significant reduction in the mean annual frequency of exacerbations and brain MRI activity after the first year of therapy. There was also no significant increase in neurological deficits according to the EDSS scale. During the safety analysis, good tolerability of the drug was noted. The spectrum of adverse events and their frequency were comparable to the data of the instructions for medical use. Conclusion. Effective treatment of MS patients requires optimizing therapy, balancing benefits and risks, and long-term treatment planning from the moment of diagnosis. All these principles can be met with an understanding of the mechanism of action of the drugs and clear adherence to recommendations for monitoring the duration of washout periods when switching from one MS-modifying drug to another.