Neurology · 2 h ago
Cladribine Cohort Shows Durable MS Control, but Many Patients Restart Treatment
In an extended follow-up of 204 people with relapsing multiple sclerosis who completed a two-year cladribine course, disease control persisted for many, but was not universal. Over a mean 44.2 months after treatment, 40.7% started another disease-modifying therapy (DMT).
- NEDA-3 survival was 56.4% at 48 months.
- Overall annualized relapse rate was 0.06.
- About 41% initiated another DMT during follow-up.
This multicenter real-world cohort included 204 patients with relapsing multiple sclerosis who completed the standard two-year cladribine regimen and had at least six months of follow-up after treatment. The investigators assessed time to loss of no evidence of disease activity (NEDA-3), annualized relapse rate (ARR), treatment re-initiation and safety. Follow-up began 24 months after the first cladribine dose and averaged 44.2 months.
Overall, 81 patients (39.7%) lost NEDA-3. NEDA-3 survival was 82.8% at 12 months, 69.6% at 24 months and 56.4% at 48 months. Forty-two patients (20.6%) relapsed; the overall ARR was 0.06, with relapse rates declining over time. MRI activity occurred in 29.9%, and 6-month confirmed disability progression in 7.4%. A subsequent DMT was initiated in 40.7%; relapses during cladribine treatment predicted earlier initiation.
The findings suggest that prolonged treatment-free disease control is possible for many patients, but not assured. As an observational cohort, the study does not establish which patients should restart therapy or when; the abstract provides no comparative treatment strategy. Continued assessment after treatment completion remains relevant to identify disease reactivation.
In practice
For people with relapsing MS who have completed the two-year cladribine regimen, this cohort indicates that disease control can persist for several years, but treatment-free remission is not universal: 40.7% began another DMT during follow-up, and NEDA-3 survival was 56.4% at 48 months. These results support the relevance of ongoing assessment after treatment completion, but the observational study does not determine who should restart therapy or establish a monitoring schedule. Its findings do not by themselves justify changing treatment decisions.
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European Journal of Neurology: Long‐Term Disease Control Following Completion of Cladribine Treatment in Multiple Sclerosis: Extended Follow‐Up of the CladStop Cohort ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.