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Background and Importance Cladribine is an immunosuppressive drug used in relapsing–remitting multiple sclerosis (RRMS), with an intermittent dosing regimen that allows long-term disease control.Aim and Objectives Evaluate the use of cladribine in a tertiary care hospital.Material and Methods A retrospective analysis was conducted with patients who completed treatment with cladribine between January 2020-August 2025. Baseline patient characteristics, the number of cladribine cycles received, and the need for subsequent disease-modifying treatment (DMT) were recorded.Results A total of 103 patients with the described characteristics were included. Baseline characteristics were: 70.87% female, median age 39 years (interquartile range (IQR): 32–46), and median time from diagnosis to initiation of cladribine of 4.75 years (IQR: 2–11.75). Information on baseline Expanded Disability Status Scale (EDSS) scores was available for 47 patients (median 2, IQR: 1–2.63). Previous DMTs were also recorded (14.56% of patients were naïve, 56.31% had received one prior DMT). Of the 103 patients, 27.18% required subsequent DMT. Among them, six patients had received only one cycle, most of these cases due to disease progression. 79 patients received two cycles of cladribine; of these, 13 did not require further DMT from the fourth year after treatment initiation, maintaining persistence of the therapeutic effect, while 22 patients did receive subsequent DMT, most commonly (nine patients) due to disease progression. Regarding the time from the start of cladribine treatment to subsequent DMT, eight patients received it at 3 years, nine at 2 years, and five at 1 year. Additionally, 18 patients received three cycles of cladribine, most of them (10 patients) in the fifth year after treatment initiation (mean 4.49 years, standard deviation 0.66). The main reason for the administration of the third cycle was disease progression.Conclusion and Relevance Many patients treated with cladribine maintained long-lasting therapeutic effects, with some continuing without the need for further DMT from the fourth year after treatment initiation. However, a significant proportion of patients required a third cycle or subsequent DMT due to disease progression. These results suggest that cladribine is an effective option for the treatment of RRMS, although continuous monitoring and individualised treatment adjustment are necessary to evaluate and optimise long-term outcomes.Conflict of Interest No conflict of interest