The Scottish Medicines Consortium (SMC) has issued its final advice, recommending restricted use of cladribine tablets (Mavenclad, Merck) for the treatment of highly active relapsing multiple sclerosis (MS).
Scotland
This decision marks a step change in the treatment options available for patients in Scotland with highly active relapsing-remitting MS as cladribine tablets are the first short-course oral therapy, with a maximum of 20 days’ tablets taken in the first two years of treatment, without the need for frequent monitoring.
Restrictions placed on the therapeutic option by the SMC include patients with rapidly evolving severe relapsing-remitting MS and patients with sub-optimal therapy relapsing-remitting MS.
Cladribine tablets were approved for use in the NHS in England and Wales by the National Institute for Health and Care Excellence (NICE) last year (October 2017). They are taken for a maximum of 10 days in the first year and a maximum of 10 days in the second year with no further treatment then required in years three and four. Additionally, the treatment should reduce the burden on healthcare services as patients can take it at home from the first dose with monitoring only required in the first two years.