Trial Outcomes & Findings for A Study of Suboptimally Controlled Participants Previously Taking Injectable DMDs for RMS (CLICK-MS) (NCT NCT03933215)

NCT ID: NCT03933215

Last Updated: 2025-04-29

Results Overview

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days).

Recruitment status

COMPLETED

Target enrollment

100 participants

Primary outcome timeframe

Baseline (Month 0) up to 24 Months

Results posted on

2025-04-29

Participant Flow

Participant milestones

Participant milestones
Measure
Cladribine
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Overall Study
STARTED
100
Overall Study
Treated
62
Overall Study
COMPLETED
34
Overall Study
NOT COMPLETED
66

Reasons for withdrawal

Reasons for withdrawal
Measure
Cladribine
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Overall Study
Other
6
Overall Study
Sponsor decision
5
Overall Study
Protocol Violation
5
Overall Study
Withdrawal by Subject
6
Overall Study
Lost to Follow-up
6
Overall Study
Enrolled but not treated
38

Baseline Characteristics

A Study of Suboptimally Controlled Participants Previously Taking Injectable DMDs for RMS (CLICK-MS)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Age, Continuous
49 years
STANDARD_DEVIATION 12.4 • n=39 Participants
Sex: Female, Male
Female
49 Participants
n=39 Participants
Sex: Female, Male
Male
13 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
51 Participants
n=39 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
9 Participants
n=39 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=39 Participants
Race (NIH/OMB)
Asian
0 Participants
n=39 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=39 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=39 Participants
Race (NIH/OMB)
White
52 Participants
n=39 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=39 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=39 Participants

PRIMARY outcome

Timeframe: Baseline (Month 0) up to 24 Months

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall number of participants analyzed" signifies those participants who were evaluable for this outcome measure.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days).

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Annualized Relapse Rate (ARR)
0.02 relapses per year
Interval 0.0 to 0.059

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The TSQM-14 was a participant-rated scale used to assess subjective satisfaction with medication. The TSQM has 14 questions that assesses participants' global satisfaction level with their treatment in 4 domains: side effects (There are 5 questions in the side effects domain, however one of them is a Yes/No question and there are 4 sub-components, hence a maximum score of 20), effectiveness (3 questions), global satisfaction (3 questions), and convenience (3 questions). All questions are scored from 1 (least satisfied) to 5 or 7 (most satisfied). The total score is summed for each domain to obtain: side effects (1-20), effectiveness (1-21), global satisfaction (1-17), and convenience (1-21), using transformed scores between 0 and 100. Lower total scores in each domain indicate dissatisfaction with the study medication and higher total scores indicate satisfaction.

Outcome measures

Outcome measures
Measure
Cladribine
n=10 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Global Satisfaction: change at Month 6
32.9 units on a scale
Standard Deviation 29.01
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Global Satisfaction: change at Month 12
26.2 units on a scale
Standard Deviation 21.43
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Global Satisfaction: change at Month 24
7.1 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Effectiveness: change at Month 6
24.4 units on a scale
Standard Deviation 23.45
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Effectiveness: change at Month 12
7.4 units on a scale
Standard Deviation 35.13
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Effectiveness: change at Month 24
-5.6 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Side Effects: change at Month 6
-8.8 units on a scale
Standard Deviation 41.37
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Side Effects: change at Month 12
-18.1 units on a scale
Standard Deviation 24.69
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Side Effects: change at Month 24
0.0 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Convenience: change at Month 6
35.0 units on a scale
Standard Deviation 21.44
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Convenience: change at Month 12
24.7 units on a scale
Standard Deviation 19.66
Change From Baseline in 14-Item Treatment Satisfaction Questionnaire for Medication (TSQM-14) Score at Month 6, 12 and 24
Convenience: change at Month 24
33.3 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

SF-36 was a multipurpose, participant completed, short-form health survey with 36 questions that consists of an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures. Physical component summary (PCS) is mostly contributed by physical function (PF), role physical (RP), bodily pain (BP), and general health (GH). Mental component summary (MCS) is mostly contributed by mental health (MH), role emotional (RE), social function (SF), and vitality (VT). Each component on the SF-36 item health survey is scored from 0 (best) to 100 (worst). Total score ranges from 0-100 for each component summary (i.e., PCS and MCS), where higher scores are associated with less disability and better quality of life.

Outcome measures

Outcome measures
Measure
Cladribine
n=15 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
PCS: Change at Month 6
4.1 units on a scale
Standard Deviation 6.90
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
PCS: Change at Month 12
-0.4 units on a scale
Standard Deviation 5.68
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
PCS: Change at Month 24
1.9 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
MCS: Change at Month 6
0.9 units on a scale
Standard Deviation 7.66
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
MCS: Change at Month 12
0.3 units on a scale
Standard Deviation 8.05
Change From Baseline in 36-Item Short Form Health Survey (SF-36) Score at Month 6, 12 and 24
MCS: Change at Month 24
-2.5 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

MFIS-5 is a modified form of the Fatigue Impact Scale that consists of 5 questions that assess the impact of fatigue on physical, cognitive, and psychosocial functioning, with 5 response levels ranging from 0 to 4, where 0 = (Never), 1 = (Rarely), 2 = (Sometimes), 3 = (Often), 4 = (Almost always). Total scores range from 0 to 20, with higher scores representing a greater impact of fatigue.

Outcome measures

Outcome measures
Measure
Cladribine
n=14 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Modified Fatigue Impact Scale - 5-item Version (MFIS-5) Total Score at Month 6, 12 and 24
Change at Month 6
-2.1 units on a scale
Standard Deviation 3.42
Change From Baseline in Modified Fatigue Impact Scale - 5-item Version (MFIS-5) Total Score at Month 6, 12 and 24
Change at Month 12
0.4 units on a scale
Standard Deviation 4.73
Change From Baseline in Modified Fatigue Impact Scale - 5-item Version (MFIS-5) Total Score at Month 6, 12 and 24
Change at Month 24
0.0 units on a scale
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The 7 items BDI-FS is a self-report inventory for measuring the severity of depression on a 7-item scale. The BDI-Fast Screen is scored by summing all of the highest ratings for each of the 7 items. Each item is rated on a 4-point scale ranging from 0 to 3. The maximum total score is 21. Higher scores indicate greater symptom severity.

Outcome measures

Outcome measures
Measure
Cladribine
n=13 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in 7-Item Beck-Depression Inventory-Fast Screen (BDI-FS) Total Score at Month 6, 12 and 24
Change at Month 6
-1.3 units on a scale
Standard Deviation 3.09
Change From Baseline in 7-Item Beck-Depression Inventory-Fast Screen (BDI-FS) Total Score at Month 6, 12 and 24
Change at Month 12
-0.1 units on a scale
Standard Deviation 3.04
Change From Baseline in 7-Item Beck-Depression Inventory-Fast Screen (BDI-FS) Total Score at Month 6, 12 and 24
Change at Month 24
-1.0 units on a scale
Standard Deviation 2.83

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The WPAI-MS questionnaire is a 6-items validated instrument to measure impairments in work and activities. The WPAI-MS included 6 questions: 1 (if currently employed); 2 (hours missed due to disease); 3 (hours missed other reasons); 4 (hours actually worked); 5 (degree disease affected productivity while working); 6 (degree disease affected regular activities). WPAI-MS generated four component scores: percentage of work time missed (absenteeism); percentage of impairment while working (presentisms); percentage of overall work impairment (absenteeism and presentisms combined); and percentage of activity impairment. Scores for WPAI range from 0% to 100%, where 0 % indicates no impairment and 100% is total loss of work productivity/activity. Change from baseline in percent work time missed (absenteeism) was reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=13 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Percent Work Time Missed Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 6
3.1 percentage of work time missed
Standard Deviation 16.37
Change From Baseline in Percent Work Time Missed Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 12
-6.3 percentage of work time missed
Standard Deviation 28.64
Change From Baseline in Percent Work Time Missed Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 24
0.0 percentage of work time missed
Standard Deviation 0.00

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The WPAI-MS questionnaire is a 6-items validated instrument to measure impairments in work and activities. The WPAI-MS included 6 questions: 1 (if currently employed); 2 (hours missed due to disease); 3 (hours missed other reasons); 4 (hours actually worked); 5 (degree disease affected productivity while working); 6 (degree disease affected regular activities). WPAI-MS generated four component scores: percentage of work time missed (absenteeism); percentage of impairment while working (presentisms); percentage of overall work impairment (absenteeism and presentisms combined); and percentage of activity impairment. Scores for WPAI range from 0% to 100%, where 0 % indicates no impairment and 100% is total loss of work productivity/activity. Change from baseline in percentage of impairment while working (presentisms) was reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=13 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Percent Impairment While Working Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 6
-11.4 percentage of impairment while working
Standard Deviation 6.90
Change From Baseline in Percent Impairment While Working Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 12
-5.0 percentage of impairment while working
Standard Deviation 22.24
Change From Baseline in Percent Impairment While Working Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 24
0.0 percentage of impairment while working
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The WPAI-MS questionnaire is a 6-items validated instrument to measure impairments in work and activities. The WPAI-MS included 6 questions: 1 (if currently employed); 2 (hours missed due to disease); 3 (hours missed other reasons); 4 (hours actually worked); 5 (degree disease affected productivity while working); 6 (degree disease affected regular activities). WPAI-MS generated four component scores: percentage of work time missed (absenteeism); percentage of impairment while working (presentisms); percentage of overall work impairment (absenteeism and presentisms combined); and percentage of activity impairment. Scores for WPAI range from 0% to 100%, where 0 % indicates no impairment and 100% is total loss of work productivity/activity. Change from baseline in total percentage of work impairment (absenteeism and presentisms) were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=13 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Percent Overall Work Impairment Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 6
-5.1 percentage of overall work impairment
Standard Deviation 18.73
Change From Baseline in Percent Overall Work Impairment Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 12
-6.1 percentage of overall work impairment
Standard Deviation 19.99
Change From Baseline in Percent Overall Work Impairment Assessed by 6-Item Work Productivity Activity Impairment - Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 24
0.0 percentage of overall work impairment
Standard Deviation NA
The standard deviation could not be calculated with data from only 1 participant.

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The WPAI-MS questionnaire is a 6-items validated instrument to measure impairments in work and activities. The WPAI-MS included 6 questions: 1 (if currently employed); 2 (hours missed due to disease); 3 (hours missed other reasons); 4 (hours actually worked); 5 (degree disease affected productivity while working); 6 (degree disease affected regular activities). WPAI-MS generated four component scores: percentage of work time missed (absenteeism); percentage of impairment while working (presentisms); percentage of overall work impairment (absenteeism and presentisms combined); and percentage of activity impairment. Scores for WPAI range from 0% to 100%, where 0 % indicates no impairment and 100% is total loss of work productivity/activity. Change from baseline in percent activity impairment was reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=13 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Percent Activity Impairment Assessed by 6-Item Work Productivity Activity Impairment- Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 6
-10.0 percentage of activity impairment
Standard Deviation 10.00
Change From Baseline in Percent Activity Impairment Assessed by 6-Item Work Productivity Activity Impairment- Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 12
-7.7 percentage of activity impairment
Standard Deviation 21.27
Change From Baseline in Percent Activity Impairment Assessed by 6-Item Work Productivity Activity Impairment- Multiple Sclerosis (WPAI-MS) Score at Month 6, 12 and 24
Change at Month 24
-5.0 percentage of activity impairment
Standard Deviation 7.07

SECONDARY outcome

Timeframe: Baseline (Month 0), Month 6, 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those who were evaluable for specified categories.

PDDS scale developed to assess the disability in Multiple Sclerosis (MS) participants and in assessing disease progression that focuses mainly on how participants walk. PDDS scale ranges from 0 to 8, where 0 = normal; 1 = mild disability; 2 = moderate disability; 3 = gait disability; 4 = early cane; 5 = late cane; 6 = bilateral support; 7 = wheelchair/scooter and 8 = bedridden. A higher score represented higher level of disability.

Outcome measures

Outcome measures
Measure
Cladribine
n=26 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Change From Baseline in Patient Determined Disease Steps (PDDS) Scale Total Score at Month 6, 12 and 24
Change at Month 6
-0.2 units on a scale
Standard Deviation 0.69
Change From Baseline in Patient Determined Disease Steps (PDDS) Scale Total Score at Month 6, 12 and 24
Change at Month 12
-0.3 units on a scale
Standard Deviation 0.72
Change From Baseline in Patient Determined Disease Steps (PDDS) Scale Total Score at Month 6, 12 and 24
Change at Month 24
-0.1 units on a scale
Standard Deviation 1.17

SECONDARY outcome

Timeframe: Baseline (Month 0) and Months 1, 2, 13 and 14

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure. "Number of participants analyzed at timepoint" signifies those participants who were evaluable for this outcome measure at each specified timepoints.

7 Treatment adherence questions, based on MS-TAQ, were developed to determine level of adherence as well as identify barriers to adherence for MS participants taking DMDs. 1.What treatment week of cladribine (Clad.) tablets (tab.) did you most recently complete? 2.How many Clad. tab. were you supposed to take during this treatment week? 3.Did you miss/forget to take any Clad. tab. during this treatment week? 4. How many Clad. tab. did you miss/ forget to take? 5.How important were following factors in missing/forgetting to take a dose? (scale from 0-3, where, 0=Not important at all and 3=Extremely important). 6.Overall, how hard/easy do you feel it is to take Clad. tab. as recommended by your physician during your treatment week? (scale from 1- 5, where 1=Extremely easy and 5=Extremely hard). 7.How satisfied are you with how things have been with your Clad. tab. treatment during your treatment week? (scale from 1-5, where 1=Not satisfied at all and 5=Completely satisfied).

Outcome measures

Outcome measures
Measure
Cladribine
n=40 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Number of Participants With Adherence to Cladribine as Assessed by Modified Versions of the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)
At Baseline
28 Participants
Number of Participants With Adherence to Cladribine as Assessed by Modified Versions of the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)
Month 1
38 Participants
Number of Participants With Adherence to Cladribine as Assessed by Modified Versions of the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)
Month 2
38 Participants
Number of Participants With Adherence to Cladribine as Assessed by Modified Versions of the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)
Month 13
21 Participants
Number of Participants With Adherence to Cladribine as Assessed by Modified Versions of the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)
Month 14
18 Participants

SECONDARY outcome

Timeframe: Months 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days). Percentage of participants who experienced relapse at Months 12 and 24 were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Percentage of Participants Who Experienced Relapse at Months 12 and 24
Month 12
1.6 percentage of participants
Percentage of Participants Who Experienced Relapse at Months 12 and 24
Month 24
1.6 percentage of participants

SECONDARY outcome

Timeframe: At Month 12

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days).

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Annualized Relapse Rate (ARR) at Month 12
0.01955 relapses per year
Interval 0.0 to 0.1

SECONDARY outcome

Timeframe: Months 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days). Percentage of participants who experienced relapse associated with hospitalization at Months 12 and 24 were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Percentage of Participants Who Experienced Relapse Associated With Hospitalization
Month 12
0.0 percentage of participants
Percentage of Participants Who Experienced Relapse Associated With Hospitalization
Month 24
0.0 percentage of participants

SECONDARY outcome

Timeframe: Months 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days). ARR associated with hospitalization at Months 12 and 24 were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Annualized Relapse Rate (ARR) Associated With Hospitalization at Months 12 and 24
Month 12
0.0 relapses per year
Interval 0.0 to
The upper limit of 95% confidence interval was not calculated as none of the participant had relapse.
Annualized Relapse Rate (ARR) Associated With Hospitalization at Months 12 and 24
Month 24
0.0 relapses per year
Interval 0.0 to
The upper limit of 95% confidence interval was not calculated as none of the participant had relapse.

SECONDARY outcome

Timeframe: Months 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure.

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days).Percentage of participants who experienced relapse associated with glucocorticoid use at Months 12 and 24 were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Percentage of Participants Who Experienced Relapse Associated With Glucocorticoid Use
Month 12
0.0 percentage of participants
Percentage of Participants Who Experienced Relapse Associated With Glucocorticoid Use
Month 24
0.0 percentage of participants

SECONDARY outcome

Timeframe: Months 12 and 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets. Here, "overall Number of participants analyzed" signifies those participants who were evaluable for this outcome measure and "number analyzed" signifies those participants who were evaluable at each specified timepoints..

The qualifying relapse is the occurrence of new or worsening neurological symptoms attributable to Multiple Sclerosis (MS) (for more than \[\>\] 24 hours, no fever, infection, injury, adverse events (AEs), and preceded by a stable or improving neurological state for more than or equal to \[\>=\] 30 days). ARR associated with glucocorticoid use at Months 12 and 24 were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=51 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Annualized Relapse Rate (ARR) Associated With Glucocorticoid Use at Months 12 and 24
Month 12
0.0 relapses per year
Interval 0.0 to
The upper limit of 95% confidence interval was not calculated as none of the participant had relapse.
Annualized Relapse Rate (ARR) Associated With Glucocorticoid Use at Months 12 and 24
Month 24
0.0 relapses per year
Interval 0.0 to
The upper limit of 95% confidence interval was not calculated as none of the participant had relapse.

SECONDARY outcome

Timeframe: At Baseline

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Number of previous DMD received by participants with MS were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Number of Previous Disease-Modifying Drugs (DMD) Received for Multiple Sclerosis (MS) at Baseline
1.9 number of DMDs received
Standard Deviation 1.14

SECONDARY outcome

Timeframe: Baseline up to Month 24

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Number of participants who received at least one concomitant medication were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Number of Participants Who Received At Least One Concomitant Medication
60 Participants

SECONDARY outcome

Timeframe: Baseline (Month 0) up to 24 Months

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Percentage of participants who discontinued cladribine tablets were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Percentage of Participants Who Discontinued Cladribine Tablets
32.3 percentage of participants

SECONDARY outcome

Timeframe: Baseline (Month 0) up to 24 Months

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Elapsed time to discontinuation after first dose of cladribine tablets was reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Elapsed Time to Discontinuation After First Dose of Cladribine Tablets
13.2 months
Interval 12.2 to 14.1

SECONDARY outcome

Timeframe: Baseline (Month 0) up to 24 Months

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Number of doses received by participants as per United States prescribing information were reported.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Number of Doses Received by Participants as Per United States Prescribing Information
28.00 number of doses received
Interval 18.0 to 34.0

SECONDARY outcome

Timeframe: Baseline (Month 0) up to 24 Months

Population: The Full Analysis Set (FAS) included all participants enrolled in the study who received at least 1 dose of cladribine tablets.

Treatment compliance was defined as total actual number of cladribine tablets / total planned number of cladribine tablets.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Percentage of Participants With Treatment Compliance as Per United States Prescribing Information
82.3 percentage of participants

SECONDARY outcome

Timeframe: Baseline (Month 0) up to 24 months

Population: The Safety Analysis Set (SAF) included all participant enrolled in the study who have received at least 1 dose of cladribine tablets.

A serious adverse event (SAE) is an adverse event (AE) that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or is otherwise considered medically important. An ADR is a response to a medicinal product which is noxious and unintended. An AESI is an AE of scientific and medical concern specific to the Sponsor's product or program, for which ongoing monitoring and rapid communication by the investigator to the Sponsor can be appropriate.

Outcome measures

Outcome measures
Measure
Cladribine
n=62 Participants
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Number of Participants With Serious Adverse Events (SAEs), Adverse Drug Reactions (ADRs) and Adverse Events of Special Interest (AESIs)
SAE
3 Participants
Number of Participants With Serious Adverse Events (SAEs), Adverse Drug Reactions (ADRs) and Adverse Events of Special Interest (AESIs)
ADR
18 Participants
Number of Participants With Serious Adverse Events (SAEs), Adverse Drug Reactions (ADRs) and Adverse Events of Special Interest (AESIs)
AESI
9 Participants

Adverse Events

Cladribine

Serious events: 3 serious events
Other events: 34 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Cladribine
n=62 participants at risk
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Gastrointestinal disorders
Gastritis
1.6%
1/62 • Baseline up to 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Anal squamous cell carcinoma
1.6%
1/62 • Baseline up to 24 months
Investigations
Low absolute lymphocyte count
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Suspected infection of the kidney
1.6%
1/62 • Baseline up to 24 months

Other adverse events

Other adverse events
Measure
Cladribine
n=62 participants at risk
Participants received cladribine tablets as per investigator discretion and as per United States approved label: 3.5 milligram/kilogram (mg/kg) body weight over 2 years, administered as 1 treatment course of 1.75 mg/kg per year.
Blood and lymphatic system disorders
Anaemia
1.6%
1/62 • Baseline up to 24 months
Blood and lymphatic system disorders
Lymphadenitis
1.6%
1/62 • Baseline up to 24 months
Blood and lymphatic system disorders
Lymphopenia
14.5%
9/62 • Baseline up to 24 months
Ear and labyrinth disorders
Eustachian tube dysfunction
1.6%
1/62 • Baseline up to 24 months
Ear and labyrinth disorders
Vertigo positional
1.6%
1/62 • Baseline up to 24 months
Endocrine disorders
Thyroid disorder
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Abdominal discomfort
3.2%
2/62 • Baseline up to 24 months
Gastrointestinal disorders
Diarrhoea
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Gastrointestinal pain
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Haemorrhoids
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Irritable bowel syndrome
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Nausea
3.2%
2/62 • Baseline up to 24 months
General disorders
Asthenia
1.6%
1/62 • Baseline up to 24 months
General disorders
Fatigue
1.6%
1/62 • Baseline up to 24 months
General disorders
Pyrexia
3.2%
2/62 • Baseline up to 24 months
Immune system disorders
Hypersensitivity
3.2%
2/62 • Baseline up to 24 months
Infections and infestations
Bronchitis
3.2%
2/62 • Baseline up to 24 months
Infections and infestations
COVID-19
8.1%
5/62 • Baseline up to 24 months
Infections and infestations
Croup infectious
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Diverticulitis
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Fungal infection
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Herpes zoster
6.5%
4/62 • Baseline up to 24 months
Infections and infestations
Hordeolum
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Nasopharyngitis
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Pharyngitis
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Staphylococcal skin infection
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Upper respiratory tract infection
3.2%
2/62 • Baseline up to 24 months
Infections and infestations
Urinary tract infection
4.8%
3/62 • Baseline up to 24 months
Injury, poisoning and procedural complications
Foot fracture
1.6%
1/62 • Baseline up to 24 months
Injury, poisoning and procedural complications
Hand fracture
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Muscle spasms
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Myalgia
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Pain in extremity
3.2%
2/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Psoriatic arthropathy
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Tendon calcification
1.6%
1/62 • Baseline up to 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Basal cell carcinoma
1.6%
1/62 • Baseline up to 24 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Benign neoplasm
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Balance disorder
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Disturbance in attention
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Dizziness
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Headache
3.2%
2/62 • Baseline up to 24 months
Nervous system disorders
Memory impairment
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Multiple sclerosis relapse
1.6%
1/62 • Baseline up to 24 months
Psychiatric disorders
Anxiety
1.6%
1/62 • Baseline up to 24 months
Renal and urinary disorders
Hypertonic bladder
1.6%
1/62 • Baseline up to 24 months
Skin and subcutaneous tissue disorders
Seborrhoeic dermatitis
1.6%
1/62 • Baseline up to 24 months
Endocrine disorders
Hypothyroidism
1.6%
1/62 • Baseline up to 24 months
Eye disorders
Swelling of eyelid
1.6%
1/62 • Baseline up to 24 months
Gastrointestinal disorders
Dyspepsia
1.6%
1/62 • Baseline up to 24 months
General disorders
Adverse drug reaction
1.6%
1/62 • Baseline up to 24 months
General disorders
Oedema peripheral
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Bacterial vulvovaginitis
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Gastroenteritis viral
1.6%
1/62 • Baseline up to 24 months
Infections and infestations
Herpes simplex
1.6%
1/62 • Baseline up to 24 months
Injury, poisoning and procedural complications
Fall
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Back pain
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Intervertebral disc disorder
1.6%
1/62 • Baseline up to 24 months
Musculoskeletal and connective tissue disorders
Musculoskeletal chest pain
1.6%
1/62 • Baseline up to 24 months
Nervous system disorders
Lumbar radiculopathy
1.6%
1/62 • Baseline up to 24 months
Psychiatric disorders
Borderline personality disorder
1.6%
1/62 • Baseline up to 24 months
Renal and urinary disorders
Nephrolithiasis
1.6%
1/62 • Baseline up to 24 months
Respiratory, thoracic and mediastinal disorders
Throat tightness
1.6%
1/62 • Baseline up to 24 months
Respiratory, thoracic and mediastinal disorders
Wheezing
1.6%
1/62 • Baseline up to 24 months
Skin and subcutaneous tissue disorders
Rash
1.6%
1/62 • Baseline up to 24 months
Skin and subcutaneous tissue disorders
Pruritus
1.6%
1/62 • Baseline up to 24 months

Additional Information

Communication Center

Merck Healthcare KGaA, Darmstadt Germany, an affiliate of Merck KGaA, Darmstadt, Germany

Phone: +49-6151-72-5200

Results disclosure agreements

  • Principal investigator is a sponsor employee Sponsor must be notified of plans to present or publish data. Presentations and/or publications require pre-submission review and approval by sponsor. Sponsor maintains right to delay publication to protect IP rights.
  • Publication restrictions are in place

Restriction type: OTHER