Shutterstock.com
The National Institute for Health and Care Excellence (NICE) has expanded access to cladribine (Mavenclad; Merck) for adults with active relapsing-remitting multiple sclerosis (MS), if they would otherwise be offered highly effective disease-modifying drugs.
The technology appraisal guidance, published on 15 April 2025, said that cladribine can be offered to people with MS as an alternative to Ocrevus (ocrelizumab; Roche Products) or Kesimpta (ofatumumab; Novartis) on the NHS.
It can also be offered if a person cannot take other high-efficacy disease-modifying drugs because they plan a pregnancy.
Cladribine is recommended as an option for treating active relapsing forms of MS in adults, only if they have active relapsing–remitting MS and when high-efficacy disease-modifying therapies would be offered.
It is taken as two courses of tablets taken a year apart. Each course consists of two treatment weeks.
According to NICE’s evaluation committee, clinical trial evidence from the CLARITY and CLARITY-EXT trials shows that cladribine reduces relapses and increases the time until disability progresses compared with placebo.
Lucy Taylor, chief executive of the MS Trust — which contributed to the NICE appraisal process — said: “Today’s announcement means that some people with active relapsing MS will now have more options to choose from.
“For people who are unable to take some disease-modifying drugs, or have side effects or breakthrough activity while taking them, this could mean that they still have a highly effective treatment option available.
“Having more treatment options which work around individual lifestyles is vital to living well with MS. This is a positive step in making MS care more reactive to the individual needs of people living with the disease.”
