Comparative effectiveness of cladribine tablets versus other oral disease-modifying treatments for multiple sclerosis: Results from MSBase registry

Tim Spelman, Serkan Ozakbas, Raed Alroughani, Murat Terzi, Suzanne Hodgkinson, Guy Laureys, Tomas Kalincik, Anneke Van Der Walt, Bassem Yamout, Jeannette Lechner-Scott, Aysun Soysal, Jens Kuhle, Jose Luis Sanchez-Menoyo, Yolanda Blanco Morgado, Daniele LA Spitaleri, Vincent van Pesch, Dana Horakova, Radek Ampapa, Francesco Patti, Richard MacdonellAbdullah Al-Asmi, Oliver Gerlach, Jiwon Oh, Ayse Altintas, Namita Tundia, Schiffon L Wong, Helmut Butzkueven

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


BACKGROUND: Effectiveness of cladribine tablets, an oral disease-modifying treatment (DMT) for multiple sclerosis (MS), was established in clinical trials and confirmed with real-world experience.

OBJECTIVES: Use real-world data to compare treatment patterns and clinical outcomes in people with MS (pwMS) treated with cladribine tablets versus other oral DMTs.

METHODS: Retrospective treatment comparisons were based on data from the international MSBase registry. Eligible pwMS started treatment with cladribine, fingolimod, dimethyl fumarate, or teriflunomide tablets from 2018 to mid-2021 and were censored at treatment discontinuation/switch, death, loss to follow-up, pregnancy, or study period end. Treatment persistence was evaluated as time to discontinuation/switch; relapse outcomes included time to first relapse and annualized relapse rate (ARR).

RESULTS: Cohorts included 633 pwMS receiving cladribine tablets, 1195 receiving fingolimod, 912 receiving dimethyl fumarate, and 735 receiving teriflunomide. Individuals treated with fingolimod, dimethyl fumarate, or teriflunomide switched treatment significantly more quickly than matched cladribine tablet cohorts (adjusted hazard ratio (95% confidence interval): 4.00 (2.54-6.32), 7.04 (4.16-11.93), and 6.52 (3.79-11.22), respectively). Cladribine tablet cohorts had significantly longer time-to-treatment discontinuation, time to first relapse, and lower ARR, compared with other oral DMT cohorts.

CONCLUSION: Cladribine tablets were associated with a significantly greater real-world treatment persistence and more favorable relapse outcomes than all oral DMT comparators.

Original languageEnglish
Pages (from-to)13524585221137502
Number of pages15
JournalMultiple Sclerosis Journal
Issue number2
Early online dateNov 26 2022
Publication statusPublished - Nov 26 2022


  • disability
  • discontinuation
  • MS
  • real-world data
  • registry
  • relapse
  • switching

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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