Real-world outcomes of cladribine in people ≥55 years of age with multiple sclerosis.

BACKGROUND

Treatment strategies for older adults with relapsing multiple sclerosis (RMS) require reassessment, particularly for those seeking to simplify or discontinue disease‑modifying therapy (DMT). Cladribine may represent a transition option. We aimed to describe clinical outcomes and treatment‑related adverse events in individuals ≥55 years with RMS who initiated cladribine within a western US health system.

METHODS

We conducted a retrospective chart review of patients ≥18 years with RMS who received at least one course of cladribine between March 2019, and April 2024.

RESULTS

Of 267 patients reviewed, 107 were ≥55 years old (72.9% female; median age 63.0 [58.4-67.2]). During a median follow‑up of 16.0 (7.0-28.0) months, the annualized relapse rate on cladribine was 0.00. Median Expanded Disability Status Scale (EDSS) at year 2 was 3.3 (2.5-6.5; n = 44). Three patients transitioned to another DMT, with a median time to new DMT of 35.0 (19.0-35.0) months.

CONCLUSIONS

In this older cohort, most patients were stable after switching to cladribine. While cladribine was generally well-tolerated, larger prospective studies are needed to better define its effectiveness in older adults with RMS.