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Thousands of patients with multiple sclerosis (MS) in England are to become the first in Europe to benefit from a major roll out of an immunotherapy pill.
Current treatments involve regular trips to hospital, drug infusions, frequent injections and extensive monitoring, which add to the burden on patients and healthcare systems.
The new tablet, cladribine, can be swallowed at home, and needs to be taken only 20 times in the first two years of a four-year cycle. The regime consists of a maximum of 10 days of treatment in the first year and 10 days in the second; no additional treatment is needed in the next two years.
Patients thinking about having children can also safely conceive in the third and fourth years of the treatment cycle. This is an important development, as MS is most commonly diagnosed in women in their 20s and 30s.
The NHS in England is the first healthcare system in Europe to widely introduce the drug to patients with active relapsing-remitting MS after it received the go-ahead from the National Institute for Health and Care Excellence (Nice).
It was previously approved only for patients with more severe, highly active MS, but cladribine, made by Merck, will now be available to many more patients.
MS is a debilitating neurological condition affecting the brain and spinal cord, causing severe pain, fatigue, cognitive issues and vision problems.
More than 150,000 people in the UK live with the condition; when first told they have MS, about 85% are diagnosed with the relapsing-remitting type.
As well as benefits for the patient, the rollout is expected to save thousands of clinical hours each year, freeing up NHS capacity by reducing the need for hospital appointments and time consuming treatments.
Klaus Schmierer, professor of neurology at Queen Mary University and a consultant neurologist at Barts Health NHS trust, said: “This Nice decision gives people with relapsing MS access to a disease-modifying immunotherapy that interferes very little with their daily lives.
“For many people with MS, effective immunotherapy comes with a substantial burden, such as frequent infusions at the hospital, or taking medication at home daily, which is both demanding in terms of consistency and a constant reminder of their chronic condition. These factors can interfere with work, relationships, and more generally a sense of normality.
“Cladribine’s efficacy and unique dosing regimen enable people with relapsing MS to maintain their quality of life being able to largely ‘forget’ about their immunotherapy once the two short treatment-courses have been completed.”
Prof James Palmer, medical director for specialised commissioning at NHS England, said: “The NHS is proud to be the first healthcare system in Europe to roll out this innovative ‘take at home’ tablet widely for patients with active multiple sclerosis.
“Broadening access to cladribine means thousands more patients will benefit from managing their treatment at home rather than regularly attending hospital appointments – as well as giving women with MS who want to get pregnant more flexibility to do so around their treatment.
“This decision will also significantly free up clinical time, helping clinicians see more patients and boosting NHS productivity.”
Laura Thomas, head of policy at the MS Society, welcomed the news, saying expanding choices for patients was “vital”. “We’re so glad that more people with MS will now be able to choose an effective treatment which suits their lifestyle,” she added.
Meanwhile, in another medical advance, an early study revealed an annual jab to protect against HIV “shows potential”.
Millions of people globally are at high risk of HIV and take daily pre-exposure prophylaxis (PrEP) tablets to reduce their risk. But challenges with adherence and persistence have limited their overall effect.
The new study, presented to the 2025 Conference on Retroviruses and Opportunistic Infections, found that a yearly injection, lenacapavir, made by Gilead Sciences, was “safe and well tolerated”.
“Yearly dosing of lenacapavir has the potential to further decrease current barriers to PrEP by increasing the uptake of, persistence on, and, therefore, scalability of PrEP,” experts wrote in The Lancet.
