Tejal Somvanshi
The National Health Service in England has become the first healthcare system in Europe to widely roll out cladribine, a take-at-home tablet for multiple sclerosis (MS) patients. This significant development offers a convenient alternative to hospital-based treatments for thousands of patients with active relapsing-remitting MS.
A Treatment Revolution
Cladribine, also known by its brand name Mavenclad, requires just 20 days of treatment spread over four years. This marks a dramatic shift from traditional MS therapies that involve regular hospital visits, frequent self-injections, and extensive monitoring.
“The NHS is proud to be the first healthcare system in Europe to roll out this innovative ‘take at home’ tablet widely for patients with active multiple sclerosis,” said Professor James Palmer, NHS Medical Director for Specialised Commissioning.
The National Institute for Health and Care Excellence (NICE) has approved cladribine for patients with active relapsing-remitting MS, expanding access beyond its previous approval only for those with more severe, highly active MS.
Clinical Benefits and Patient Impact
Nearly eight in ten patients taking cladribine experienced no relapses, and MRI scans showed they developed 7.5 times fewer new brain lesions compared to patients given a placebo, in clinical trials lasting almost two years.
For the estimated 150,000 people living with MS in the UK, this development represents more than just medical advancement – it offers greater independence and lifestyle flexibility.
Clare Elgar, 37, from Southampton, shared her experience: “Being able to take the treatment at home meant I could maintain my day-to-day routine and not have to travel to hospital. I’ve experienced no relapses since starting the treatment in 2021.”
Similar Posts
Benefits for Women Planning Pregnancies
One standout feature of cladribine is that patients planning pregnancies can safely conceive in years three and four of their treatment cycle, as the medication is administered in short courses over the first two years.
“This decision could particularly benefit people who’d struggle to go into hospital regularly, like younger working-age adults,” noted Laura Thomas, Head of Policy at the MS Society. “It will also benefit patients considering starting a family, as it’s safe to get pregnant six months after the final course of treatment – which is less restrictive than many other options.”
Healthcare System Advantages
The rollout is expected to save thousands of clinical hours annually by reducing hospital visits and monitoring time, freeing up NHS resources and boosting productivity.
Health Minister Ashley Dalton emphasized: “By expanding access to medicines that can be taken at home, we can shift care out of hospitals and into the community, giving patients more freedom and saving the NHS money.”
It’s estimated that about 2,000 patients could receive cladribine over the first three years of rollout.
How It Works
Cladribine is a chemotherapy drug that targets specific immune cells involved in MS. It kills certain white blood cells made by the immune system known as T and B cells, which in people with MS attack the covering around nerves in the brain and spinal cord called the myelin sheath. The drug prevents these cells from entering the brain or spinal cord and attacking the nerves.
Professor Klaus Schmierer, professor of neurology at Queen Mary University and a consultant neurologist at Barts Health NHS trust, explained: “This NICE decision gives people with relapsing MS access to a disease-modifying immunotherapy that interferes very little with their daily lives. Cladribine’s efficacy and unique dosing regimen enable people with relapsing MS to maintain their quality of life being able to largely ‘forget’ about their immunotherapy once the two short treatment-courses have been completed.”
This development aligns with the NHS’s broader commitment to innovation and patient-centered care, following recent successes in delivering an extra 2.2 million planned appointments between July and November 2024 — achieving the government’s productivity ambition seven months ahead of schedule.
FAQs
What is cladribine and how does it work for MS patients?
Cladribine (brand name Mavenclad) is a take-at-home tablet that treats multiple sclerosis by targeting specific immune cells involved in MS. It kills certain white blood cells (T and B cells) that attack the myelin sheath covering nerves in the brain and spinal cord. The drug prevents these cells from entering the central nervous system and causing damage, helping to reduce relapses and slow disease progression.
How is cladribine administered and how often do patients need to take it?
Cladribine requires just 20 days of treatment spread over four years. The regimen consists of a maximum of 10 days of treatment in the first year and 10 days in the second year. No additional treatment is needed in the third and fourth years of the cycle.
Is cladribine safe for women who want to get pregnant?
Yes, cladribine allows women to safely conceive in years three and four of their treatment cycle. According to the MS Society, it’s safe to get pregnant six months after the final course of treatment, which is less restrictive than many other MS treatment options.
How effective is cladribine compared to other MS treatments?
Nearly eight in ten patients taking cladribine experienced no relapses, and MRI scans showed they developed 7.5 times fewer new brain lesions compared to patients given a placebo, in clinical trials lasting almost two years. It offers comparable clinical benefits to current treatments while significantly reducing hospital visits and clinical monitoring time.
How many patients in England could benefit from this new MS tablet?
It’s estimated that about 2,000 patients could be offered cladribine treatment over the first three years of the rollout. With more than 150,000 people living with MS in the UK, this represents an important expansion of treatment options for those with active relapsing-remitting MS.
How much does cladribine cost and will it save the NHS money?
The list price for cladribine is around £2,000 per tablet, though the NHS can negotiate discounts with drug companies. While the exact cost to the NHS isn’t clear, officials state the rollout will save thousands of clinical hours each year by reducing hospital visits and monitoring time. This shift to home-based care is expected to free up NHS resources and boost overall healthcare system productivity.
