{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:21:39Z","timestamp":1792693299601,"version":"4.5.0"},"reference-count":44,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck & Co Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.msard.2026.107214","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:02:15Z","timestamp":1777701735000},"page":"107214","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Updated systematic literature review and network meta-analysis of cladribine tablets versus currently approved disease-modifying treatments for active relapsing-remitting multiple sclerosis"],"prefix":"10.1016","volume":"111","author":[{"given":"Gerard T.","family":"Harty","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikalp","family":"Maheshwari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Saipriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.msard.2026.107214_bib0002","doi-asserted-by":"crossref","first-page":"47","DOI":"10.2217\/nmt-2021-0058","article-title":"Updates and advances in multiple sclerosis neurotherapeutics","volume":"13","author":"Amin","year":"2023","journal-title":"Neurodegener. Dis. Manag."},{"issue":"9139","key":"10.1016\/j.msard.2026.107214_bib0001","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/S0140-6736(98)03334-0","article-title":"Randomised double-blind placebo-controlled study of interferon beta-1a in relapsing\/remitting multiple sclerosis. PRISMS (Prevention of Relapses and Disability by Interferon beta-1a Subcutaneously in Multiple Sclerosis) Study Group","volume":"352","year":"1998","journal-title":"Lancet"},{"issue":"8","key":"10.1016\/j.msard.2026.107214_bib0003","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1080\/03007995.2019.1585779","volume":"35","author":"Berardi","year":"2019","journal-title":"Curr. Med. Res. Opin."},{"issue":"5","key":"10.1016\/j.msard.2026.107214_bib0004","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1056\/NEJMoa0907839","article-title":"Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis","volume":"362","author":"Cohen","year":"2010","journal-title":"N. Engl. J. Med."},{"issue":"9856","key":"10.1016\/j.msard.2026.107214_bib0005","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1016\/S0140-6736(12)61769-3","article-title":"Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial","volume":"380","author":"Cohen","year":"2012","journal-title":"Lancet"},{"issue":"17","key":"10.1016\/j.msard.2026.107214_bib0006","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1056\/NEJMoa0802670","article-title":"Alemtuzumab vs. interferon beta-1a in early multiple sclerosis","volume":"359","author":"Coles","year":"2008","journal-title":"N. Engl. J. Med."},{"issue":"9856","key":"10.1016\/j.msard.2026.107214_bib0007","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/S0140-6736(12)61768-1","article-title":"Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial","volume":"380","author":"Coles","year":"2012","journal-title":"Lancet"},{"issue":"12","key":"10.1016\/j.msard.2026.107214_bib0008","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1007\/s00415-017-8642-5","article-title":"Efficacy of fingolimod and interferon beta-1b on cognitive, MRI, and clinical outcomes in relapsing-remitting multiple sclerosis: an 18-month, open-label, rater-blinded, randomised, multicentre study (the GOLDEN study)","volume":"264","author":"Comi","year":"2017","journal-title":"J. Neurol."},{"issue":"3","key":"10.1016\/j.msard.2026.107214_bib0009","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S1474-4422(13)70308-9","article-title":"Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"13","author":"Confavreux","year":"2014","journal-title":"Lancet Neurol."},{"key":"10.1016\/j.msard.2026.107214_bib0010","doi-asserted-by":"crossref","DOI":"10.1177\/1756286418774338","article-title":"Phase IV study of retention on fingolimod versus injectable multiple sclerosis therapies: a randomized clinical trial","volume":"11","author":"Cree","year":"2018","journal-title":"Ther. Adv. Neurol. Disord."},{"issue":"7\u20138","key":"10.1016\/j.msard.2026.107214_bib0012","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1002\/sim.3767","article-title":"Checking consistency in mixed treatment comparison meta-analysis","volume":"29","author":"Dias","year":"2010","journal-title":"Stat. Med."},{"issue":"5","key":"10.1016\/j.msard.2026.107214_bib0011","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1177\/0272989X12458724","article-title":"Evidence synthesis for decision making 2: a generalized linear modeling framework for pairwise and network meta-analysis of randomized controlled trials","volume":"33","author":"Dias","year":"2013","journal-title":"Med. Decis. Making"},{"key":"10.1016\/j.msard.2026.107214_bib0013","unstructured":"Electronic Medicines Compendium. (2011) Electronic medicines compendium. http:\/\/emc.medicines.org.uk\/ Accessed Aug. 2011."},{"key":"10.1016\/j.msard.2026.107214_bib0014","unstructured":"European Medicines Agency. EPAR summary for the public. Mavenclad. London, UK. Available at: http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Summary_for_the_public\/human\/004230\/WC500234564.pdf [Last accessed 5 May 2024]."},{"key":"10.1016\/j.msard.2026.107214_bib0015","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.msard.2017.07.003","article-title":"Is there a change of paradigm towards more effective treatment early in the course of apparent high-risk MS?","volume":"17","author":"Fernandez","year":"2017","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2026.107214_bib0016","unstructured":"Food and Drug Administration. Mavenclad. Available at: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2019\/022561Orig1s000Approv.pdf [Last accessed 5 May 2024]."},{"issue":"12","key":"10.1016\/j.msard.2026.107214_bib0017","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1056\/NEJMoa1206328","article-title":"Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis","volume":"367","author":"Fox","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.msard.2026.107214_bib0018","unstructured":"G-BA. 2011. \"The benefit assessment of pharmaceuticals in accordance with the German Social Code, Book Five (SGB V), section 35a.\" In."},{"issue":"5","key":"10.1016\/j.msard.2026.107214_bib0019","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1056\/NEJMoa0902533","article-title":"A placebo-controlled trial of oral cladribine for relapsing multiple sclerosis","volume":"362","author":"Giovannoni","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.msard.2026.107214_bib0020","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.86.16_supplement.P3.028","article-title":"Clinical efficacy of cladribine tablets in patients with relapsing-remitting multiple sclerosis (RRMS): final results from the 120-week phase IIIb extension trial to the CLARITY study (P3.028)","volume":"86","author":"Giovannoni","year":"2016","journal-title":"Neurology"},{"key":"10.1016\/j.msard.2026.107214_bib0021","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1177\/1352458518771875","article-title":"Efficacy of Cladribine Tablets in high disease activity subgroups of patients with relapsing multiple sclerosis: a post hoc analysis of the CLARITY study","volume":"25","author":"Giovannoni","year":"2019","journal-title":"Mult. Scler."},{"issue":"12","key":"10.1016\/j.msard.2026.107214_bib0022","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1056\/NEJMoa1114287","article-title":"Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis","volume":"367","author":"Gold","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.msard.2026.107214_bib0023","unstructured":"HAS. 2000. \"Analysis of the literature and recommendations grading guide.\" In."},{"issue":"3","key":"10.1016\/j.msard.2026.107214_bib0024","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013430","article-title":"Systematic literature review and network meta-analysis in highly active relapsing-remitting multiple sclerosis and rapidly evolving severe multiple sclerosis","volume":"7","author":"Huisman","year":"2017","journal-title":"BMJ Open"},{"issue":"1","key":"10.1016\/j.msard.2026.107214_bib0025","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996","journal-title":"Control. Clin. Trials"},{"issue":"5","key":"10.1016\/j.msard.2026.107214_bib0026","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1056\/NEJMoa0909494","article-title":"A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis","volume":"362","author":"Kappos","year":"2010","journal-title":"N. Engl. J. Med."},{"issue":"3","key":"10.1016\/j.msard.2026.107214_bib0027","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1474-4422(14)70005-5","article-title":"Effect of oral cladribine on time to conversion to clinically definite multiple sclerosis in patients with a first demyelinating event (ORACLE MS): a phase 3 randomised trial","volume":"13","author":"Leist","year":"2014","journal-title":"Lancet Neurol."},{"issue":"3","key":"10.1016\/j.msard.2026.107214_bib0028","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2174\/157015911796557911","article-title":"Multiple sclerosis: pathogenesis and treatment","volume":"9","author":"Loma","year":"2011","journal-title":"Curr. Neuropharmacol."},{"issue":"10","key":"10.1016\/j.msard.2026.107214_bib0029","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1007\/s00702-013-1079-9","article-title":"Is MS an inflammatory or primary degenerative disease?","volume":"120","author":"Losy","year":"2013","journal-title":"J. Neural Transm."},{"issue":"3","key":"10.1016\/j.msard.2026.107214_bib0030","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1212\/WNL.0000000000000560","article-title":"Defining the clinical course of multiple sclerosis: the 2013 revisions","volume":"83","author":"Lublin","year":"2014","journal-title":"Neurology"},{"issue":"10","key":"10.1016\/j.msard.2026.107214_bib0031","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s40263-016-0377-9","article-title":"Benefit-risk of therapies for relapsing-remitting multiple sclerosis: testing the number needed to treat to Benefit (NNTB), number needed to treat to harm (NNTH) and the likelihood to be helped or harmed (LHH): a systematic review and meta-analysis","volume":"30","author":"Mendes","year":"2016","journal-title":"CNS Drugs"},{"issue":"11","key":"10.1016\/j.msard.2026.107214_bib0032","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1136\/jnnp-2013-304951","article-title":"Characterising aggressive multiple sclerosis","volume":"84","author":"Menon","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"10.1016\/j.msard.2026.107214_bib0038","unstructured":"Merck Serono. CLARITY clinical trial report 2010 [Last accessed 28 November 2024]."},{"issue":"7","key":"10.1016\/j.msard.2026.107214_bib0033","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"10.1016\/j.msard.2026.107214_bib0034","unstructured":"NICE. (2013) NICE DSU Technical Support Document 2: a generalised linear modelling framework for pairwise and network Meta-analysis of randomised controlled trials. 2011. www.nicedsu.org.uk."},{"issue":"9","key":"10.1016\/j.msard.2026.107214_bib0035","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1056\/NEJMoa044397","article-title":"A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis","volume":"354","author":"Polman","year":"2006","journal-title":"N. Engl. J. Med."},{"issue":"7","key":"10.1016\/j.msard.2026.107214_bib0036","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1038\/nrneurol.2015.85","article-title":"Aggressive multiple sclerosis: proposed definition and treatment algorithm","volume":"11","author":"Rush","year":"2015","journal-title":"Nat. Rev. Neurol."},{"key":"10.1016\/j.msard.2026.107214_bib0037","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.msard.2016.11.002","article-title":"Efficacy, safety, and pharmacokinetics of natalizumab in Japanese multiple sclerosis patients: a double-blind, randomized controlled trial and open-label pharmacokinetic study","volume":"11","author":"Saida","year":"2017","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"8","key":"10.1016\/j.msard.2026.107214_bib0039","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1080\/03007995.2017.1407303","article-title":"Systematic literature review and network meta-analysis of cladribine tablets versus alternative disease-modifying treatments for relapsing\u2013remitting multiple sclerosis","volume":"34","author":"Siddiqui","year":"2018","journal-title":"Curr. Med. Res. Opin."},{"key":"10.1016\/j.msard.2026.107214_bib0040","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/1471-2377-12-154","article-title":"Comparative injection-site pain and tolerability of subcutaneous serum-free formulation of interferon\u03b2-1a versus subcutaneous interferon\u03b2-1b: results of the randomized, multicenter, Phase IIIb REFORMS study","volume":"12","author":"Singer","year":"2012","journal-title":"BMC Neurol."},{"key":"10.1016\/j.msard.2026.107214_bib0041","unstructured":"STA NICE 2013. \"Specification for manufacturer\/sponsor submission of evidence June 2012.\" In. ."},{"issue":"10130","key":"10.1016\/j.msard.2026.107214_bib0042","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/S0140-6736(18)30481-1","article-title":"Multiple sclerosis","volume":"391","author":"Thompson","year":"2018","journal-title":"Lancet"},{"issue":"6","key":"10.1016\/j.msard.2026.107214_bib0043","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0127960","article-title":"A network meta-analysis of efficacy and evaluation of safety of subcutaneous pegylated interferon beta-1a versus other injectable therapies for the treatment of relapsing-remitting multiple sclerosis","volume":"10","author":"Tolley","year":"2015","journal-title":"PLoS ONE"},{"issue":"14","key":"10.1016\/j.msard.2026.107214_bib0044","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition","volume":"26","author":"Walton","year":"2020","journal-title":"Mult. Scler."}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034826002506?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034826002506?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T03:37:03Z","timestamp":1780976223000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034826002506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":44,"alternative-id":["S2211034826002506"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2026.107214","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Updated systematic literature review and network meta-analysis of cladribine tablets versus currently approved disease-modifying treatments for active relapsing-remitting multiple sclerosis","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2026.107214","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"107214"}}