Clinical experience with cladribine in patients with relapsing-remitting multiple sclerosis.

Abstract

Background: Cladribine has recently been introduced to the armamentarium of therapies for relapsing MS. Objective(s): To report relapses and disability in patients who were treated with cladribine as part of a product familiarisation program in Australia in 2011. Method(s): Patients exposed to oral cladribine, cumulative dose 1.75 mg/kg, between January and July 2011, enrolled in the MSBase registry were included. Incidence of relapses and disability (EDSS) were reported by the patients' treating physicians and recorded in the MSBase database. Result(s): This cohort of patients were older and had a higher EDSS at commencing oral cladribine than patients in the clinical trials of oral cladribine. Mean age at commencing cladribine was 47 years, age at MS onset was 34 years, duration of MS was 13 years and median EDSS score was 5.25. Disability trajectories suggested an overall increasing trend prior to treatment with cladribine, which was reduced during the 2 years following treatment. Based on EDSS scores, approximately 80% of patients were free from progression, 65% of patients remained relapse free after 2 years and median time to next DMT was 1.7 years. Conclusion(s): The data from the Australian oral cladribine product familiarisation program complement the information form clinical trials and a head-to-head comparison of observational data. This information suggests cladribine is associated with reduction in the rate of disability worsening for at least two years from the initial treatment administration. The studied data are limited and representative post-marketing studies, including safety surveillance, are needed.