MS Therapy Cladribine Remains Effective in Patients With Suboptimal Response to Prior Injectable DMT

May 14, 2025

Cladribine shows promising results in reducing relapse rates for patients with relapsing multiple sclerosis after inadequate response to injectable therapies.

MS Therapy Cladribine Remains Effective in Patients With Suboptimal Response to Prior Injectable DMT

In the phase 4 CLICK-MS study (NCT03933215), treatment with cladribine (Mavenclad; EMD Serono) following suboptimal response to prior injectable disease-modifying therapy (iDMTs) led to low annualized relapse rates (ARR) among patients with relapsing multiple sclerosis (RMS). All told, this real-world study provided greater support for patients planning to switch to cladribine following inadequate treatment response with iDMTs.¹

The observational, single-arm study comprised 62 patients with RMS who switched from an iDMT to cladribine tablets. Of these, 34 (58%) completed the 24-month study period. Presented at the 2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, in Phoenix, Arizona, results after 24 months revealed a low annualized relapse rate (ARR), at 0.02 (95% CI, 0.000-0.059), following the initiation of cladribine. Notably, at least 80.6% of patients with RMS (n = 50) remained relapse free over the 24-month period.

Led by Joshua Katz, MD, codirector of the Elliot Lewis Center for Multiple Sclerosis Care, the mean age of the sample was 49 years, with most patients female (79%) and White (83.9%). Coming into the study, the most common prior iDMTs were glatiramer acetate (56.5%) and interferon beta-1a (25.8%), followed by pegylated interferon beta-1a (6.5%) and interferon beta-1b (6.5%). Other DMTs included natalizumab (n = 3; 3.2%; patients were mistakenly enrolled into the study) and ofatumumab (n = 1; 1.6%).

Key secondary end points from the study included adherence and satisfaction as assessed by Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ), and safety. Among MS-TAQ respondents, 30% (12 of 40) reported missing doses of injectable medication prior to cladribine; however, after the switch to cladribine, self-reported treatment adherence was high among respondents. Over the 2-year period, there was only 1 patient who missed or forgot to take their cladribine dose, which occurred in the second month of year 1.

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