After MS Treatment: How Long Can Disease Stay Quiet?
By MS Buddy ·
Summarized from European journal of neurology, Nov 2026 · PubMed. AI-generated summary. Not medical advice.
Research by Irene Schiavetti, Maria Pia Sormani and 27 colleagues at Università della Campania Luigi Vanvitelli, Istituto di Ricovero e Cura a Carattere Scientifico Neuromed and 14 other institutions in Italy.
Key Takeaway
Many people with relapsing MS stayed stable for years after finishing a two-year course of cladribine, but regular checkups remained important because disease activity returned for some.
What They Found
Researchers followed 204 people with relapsing MS after they completed two years of cladribine treatment. About 56% had no new relapses, no new signs of MS on brain scans, and no lasting increase in disability four years after finishing treatment. About 21% had a relapse, meaning new or worsening MS symptoms, during follow-up. Brain scans showed new MS activity in about 30%, while about 7% had a lasting increase in disability. About 41% started another MS treatment during follow-up.
Who Should Care and Why
If you have finished cladribine, these findings suggest your MS may stay quiet for years without another treatment. Still, feeling well does not always mean MS is inactive, because a brain scan can show changes before you notice symptoms. Keep your planned appointments and scans, much like checking a smoke alarm even when you see no smoke. Tell your MS care team about new or worsening symptoms so they can help decide whether you need another treatment. Caregivers can help by supporting follow-up visits and watching for changes the person with MS may not notice.
Important Considerations
This study followed people who had completed cladribine, so its results may not apply to everyone who starts it. The researchers observed what happened in routine care rather than comparing cladribine with another treatment, so the study cannot show which treatment works best. People had different lengths of follow-up, and the results cannot predict exactly when or whether your own MS will become active again.
AI-generated summary — for informational purposes only, not medical advice
Read the original abstract
Published in European journal of neurology by et al.. Reproduced from the PubMed record.
Long-term disease control after the standard two-year cladribine course in multiple sclerosis (MS) remains insufficiently characterized in real-world settings. We evaluated disease control, treatment re-initiation, and safety during extended follow-up of the multicenter CladStop cohort after treatment completion. We included 204 patients with relapsing MS who completed the approved two-year cladribine regimen and had ≥ 6 months of follow-up after treatment completion. Time zero ("CladStop") was defined as 24 months after first cladribine dosing. Co-primary endpoints were time to loss of no evidence of disease activity (NEDA-3) and annualized relapse rate (ARR) after CladStop. Kaplan-Meier analyses, multivariable Cox models, and mixed-effects Poisson regression were applied. Mean follow-up after CladStop was 44.2 ± 8.6 months. Overall, 81/204 patients (39.7%) lost NEDA-3. NEDA-3 survival was 82.8% (95% CI 77.8-88.2) at 12 months, 69.6% (95% CI 63.6-76.2) at 24 months, and 56.4% (95% CI 49.2-64.8) at 48 months. Forty-two patients (20.6%) relapsed, with an overall ARR of 0.06 (95% CI 0.04-0.08). Relapse rates decreased over time (rate ratio/year 0.74, 95% CI 0.55-0.999; p = 0.044). MRI activity occurred in 29.9% of patients and 6-month confirmed disability progression in 7.4%. A new DMT was initiated in 40.7% of patients. Relapses during treatment predicted earlier DMT initiation. Disease control remained durable in many patients after completion of cladribine treatment. However, over 40% initiated subsequent DMT during follow-up, indicating that prolonged treatment-free remission is not universal. Disease reactivation was driven mainly by inflammatory activity rather than disability worsening.
Trials you could look into
This study looked at a treatment with MS trials currently recruiting or under way.
Listing a trial is not a recommendation. Eligibility is decided by the study team, and your neurologist is the person to ask first.
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Read MoreNot all studies carry the same weight: sample size, study design and whether results were replicated all matter. The credibility score above reflects the journal, and the original paper is linked under More Details. Read how MS Buddy selects and scores research, and talk to your MS care team before acting on any study.