{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T13:37:49Z","timestamp":1774791469585,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Cladribine tablets, a purine analogue antimetabolite, offer a unique treatment regimen, involving short courses at the start of the first and second year, with no further treatment needed in years 3 and 4. However, comprehensive evidence regarding patient outcomes beyond the initial 24\u2009months of cladribine treatment is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, multicenter study enrolled 204 patients with multiple sclerosis who had completed the 2\u2010year course of cladribine treatment. The primary outcomes were therapeutic choices and clinical disease activity assessed by annualized relapse rate after the 2\u2010year treatment course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 204 patients were enrolled; most patients (75.4%) did not initiate new treatments in the 12\u2009months postcladribine. The study found a significant reduction in annualized relapse rate at the 12\u2010month follow\u2010up after cladribine completion compared to the year prior to starting therapy (0.07\u2009\u00b1\u20090.25 vs. 0.82\u2009\u00b1\u20090.80, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Furthermore, patients with relapses during cladribine treatment were more likely to start new therapies, whereas older patients were less likely. The safety profile of cladribine was favorable, with lymphopenia being the primary registered adverse event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides insights into therapeutic choices and disease activity following cladribine treatment. It highlights cladribine's effectiveness in reducing relapse rates and disability progression, reaffirming its favorable safety profile. Real\u2010world data, aligned with previous reports, draw attention to ocrelizumab and natalizumab as common choices after cladribine. However, larger, prospective studies for validation and a more comprehensive understanding of cladribine's long\u2010term impact are necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16250","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T04:40:33Z","timestamp":1711687233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Therapeutic choices and disease activity after 2\u2009years of treatment with cladribine: An Italian multicenter study (<scp>CladStop<\/scp>)"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-2977","authenticated-orcid":false,"given":"Irene","family":"Schiavetti","sequence":"first","affiliation":[{"name":"Department of Health Sciences University of Genoa  Genova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Signori","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Genoa  Genova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Albanese","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Genoa  Genova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9068-9144","authenticated-orcid":false,"given":"Jessica","family":"Frau","sequence":"additional","affiliation":[{"name":"Centro Sclerosi Multipla Ospedale Binaghi Cagliari Azienda Sanitaria Locale (ASL) Cagliari  Cagliari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Cocco","sequence":"additional","affiliation":[{"name":"Centro Sclerosi Multipla Ospedale Binaghi Cagliari Azienda Sanitaria Locale (ASL) Cagliari  Cagliari 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Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8390-8545","authenticated-orcid":false,"given":"Diego","family":"Centonze","sequence":"additional","affiliation":[{"name":"Unit of Neurology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed  Pozzilli Italy"},{"name":"Department of Systems Medicine Tor Vergata University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3309-8417","authenticated-orcid":false,"given":"Doriana","family":"Landi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine Tor Vergata University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Girolama","family":"Marfia","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine Tor Vergata University  Rome 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