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Multiple SclerosisNCT06415864

Oral Cladribine B-cell Study

An observational study of Multiple Sclerosis, run by Queen Mary University of London at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To study the impact of cladribine on peripheral and intrathecal B-cell, plasma cells, T cells and Tregs Read more about this study

Who is it for?
Any age
Conditions the study is for
Multiple Sclerosis
Type of treatment
Pill or oral medicine
How many people
10 participants
Where
1 siteUnited Kingdom
Study dates
1 Jul 2019to 31 Jan 2024
Phase
Observational
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Relapsing-remitting MS

Who may be able to join

  • Patients with MS who are being treated with oral cladribine at Barts Health NHS Trust will be approached to participate in this study.
  • Patients must be willing and able to undergo lumbar punctures
  • Patients who are OCB positive in their CSF (previous diagnostic lumbar puncture)

Who cannot join

  • Ineligible for oral cladribine under NHS England prescribing guidelines and those participating in MAGNIFY-MS study (cladribine tablets in active MS)
  • Unsuitable to have a lumbar puncture, for example spinal deformity, tethered cord syndrome or the use of aspirin or anticoagulants, and those unable to comply with study requirements, including frequency of visits and lumbar punctures.
  • Presence of comorbidities in which the administration of cladribine is contraindicated.
  • Abnormal baseline investigations (WBC<3 x 10*9/l, lymphocytes <1.0 x 10*9/l, neutrophil count <1.5 x 10*9/l, platelet count <100 x 10*9, haemoglobin <110g/l, LFT>/3x upper limit of normal of site reference ranges, potassium <2.8mmol/l or >5.5mmol/l, sodium <125 mmol/l, creatinine >130 umol/l)

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Barts Health NHS Trust

    London

Other trials in United Kingdom

About this study

To study the impact of cladribine on peripheral and intrathecal B-cell, plasma cells, T cells and Tregs

Read the detailed description

Primary: To quantify the temporal changes of memory B cells (CD19+/CD27+/IgD-/+), plasmablasts (CD19-/CD138+/CD38+) and T cells (CD4/CD45RA-/+, CCR7-/+, CD8+/CD45RA-/+/CCR7-/+), Tregs (CD4/CD8)/CD25+/CD127-/Fox3 P+) in the peripheral venous blood of pwMS with RRMS over 96w of treatment with oral cladribine.

These will be compared to the populations of non-memory or class-switched B cells (immature/transitional B cells CD10+/CD38+/CD19+, immature regulatory B cells CD10+/CD38+/CD19+/CD24+/IL-10+, mature B cells CD10-/CD38+/CD19+).

Secondary:

  1. To study the effects of oral cladribine on:
  2. CSF OCBs and free immunoglobulin kappa and lambda light chain levels (FLC).
  3. CSF markers of inflammation, in particular CXCL-13 and urine markers of inflammation (neopterin).
  4. CSF markers of neuroaxonal damage, in particular free neurofilament light chains.
  5. On the peripheral repertoire B-cells (immunoglobulin) and T-cells (T cell receptor) and plasma cells (soluble receptors).
  6. To compare CSF OCB positivity and CSF light chain levels with a contemporary control group of alemtuzumab treated pwMS (historical data).

Tertiary:

  1. To compare B and T cell repertoire with a contemporary control group of alemtuzumab treated pwMS (historical data).
  2. To evaluate the effect of changes in the immune cell profile on clinical measures of disability, MRI activity and PROMS.
Keywords
MS
Medical subject headings
Multiple Sclerosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT06415864
Study groupRoleWhat they receive
Cladribine (Mavenclad, Merck Serono Ltd)In the summary of product characteristics the recommended cumulative dose is 3.5 mg/kg body weight over 2 years, taken as 1 treatment course of 1.75 mg/kg per year. Each treatment course consists of 2 treatment weeks, 1 at the beginning of the first month and 1 at the beginning of the second month of the respective treatment year. Each treatment week consists of 4 or 5 days on which a patient takes 10 mg or 20 mg (1 or 2 tablets) as a single daily dose, depending on body weight

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percent Change in Class-switched Memory B Cells From Baseline to Week 96 nh

    Percent change from baseline to Week 96 in class-switched memory B cells (CD19+/CD27+/IgD-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  2. Percent Change in Non Class-switched Memory B Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in non class-switched memory B cells (CD19+/CD27+/IgD+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  3. Percent Change in Plasmablast From Baseline to Week 96

    Percent change from baseline to Week 96 in plasmablasts (CD19+/CD27+/CD38+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  4. Percent Change in Transitional B Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in transitional B cells (CD19+ IgD+ CD10+ CD27-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  5. Percent Change in Regulatory B Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in regulatory B cells (CD19+/CD24+/CD38+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  6. Percent Change in CD4+ Central Memory T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD4+ central memory T cells (CD45RA- CCR7+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  7. Percent Change in CD4+ Naive T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD4+ naive T cells (CD45RA+ CCR7+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  8. Percent Change in CD4+ TEMRA Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD4+ TEMRA cells (CD45RA+ CCR7-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  9. Percent Change in CD4+ Effector Memory T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD4+ effector memory T cells (CD45RA- CCR7-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  10. Percent Change in CD8+ Central Memory T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD8+ central memory T cells (CD45RA- CCR7+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  11. Percent Change in CD8+ Naive T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD8+ naive T cells (CD45RA+ CCR7+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  12. Percent Change in CD8+ TEMRA Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD8+ TEMRA cells (CD45RA+ CCR7-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  13. Percent Change in CD8+ TEM Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in CD8+ effector memory T cells (CD45RA- CCR7-) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

  14. Percent Change in Regulatory T Cells From Baseline to Week 96

    Percent change from baseline to Week 96 in regulatory T cells (CD4+ CD25+ FOXP3+) in participants with RRMS treated with oral cladribine.

    Measured: Baseline to week 96

Secondary outcomes (8)
  1. Changes in CSF of κ Free Light Chain (KFLC) From Baseline to Week 48 and Week 96

    The CSF κ Free Light Chain (KFLC) Index and λ Free Light Chain (LFLC) Index were measured at baseline, Week 48, and Week 96. KFLC and LFLC concentrations in cerebrospinal fluid and serum were obtained using Optilite. The KFLC Index and LFLC Index were calculated as (CSF FLC / serum FLC) ÷ (CSF albumin / serum albumin). These indices provide quantitative measures of intrathecal free light chain synthesis. Values are continuous laboratory measurements and do not use a score or scale.

    Measured: Baseline to week 96

  2. Change in CSF Oligoclonal Band (OCB) Positivity From Baseline to Week 48 and Week 96

    CSF and matched serum samples were analysed for IgG oligoclonal bands using isoelectric focusing followed by immunoblotting. OCB positivity was defined as ≥1 IgG band present in CSF but absent in serum (CSF-restricted bands). Reported values include the number of OCB-positive and OCB-negative participants at each time point (baseline, Week 48, Week 96). Higher values indicate increased intrathecal IgG synthesis

    Measured: Baseline to week 96

  3. Changes in CSF of λ Free Light Chain (LFLC) Index From Baseline to Week 48 and Week 96

    The CSF κ Free Light Chain (KFLC) Index and λ Free Light Chain (LFLC) Index were measured at baseline, Week 48, and Week 96. KFLC and LFLC concentrations in cerebrospinal fluid and serum were obtained using Optilite. The KFLC Index and LFLC Index were calculated as (CSF FLC / serum FLC) ÷ (CSF albumin / serum albumin). These indices provide quantitative measures of intrathecal free light chain synthesis. Values are continuous laboratory measurements and do not use a score or scale.

    Measured: Baseline to week 96

  4. Change in CSF CXCL-13 Levels From Baseline to Week 96

    CXCL-13 concentrations in cerebrospinal fluid (CSF) were measured at baseline, Week 48, and Week 96 using immunoassay methods. Values are continuous laboratory measurements and are reported numerically (mean and standard deviation). No scoring system or clinical scale applies.

    Measured: Baseline to week 96

  5. Change in Urine Neopterin Levels From Baseline to Week 96

    Urine neopterin concentrations were measured at baseline, Week 48, and Week 96 using immunoassay methods. Values are continuous laboratory measurements and are reported numerically (mean and standard deviation). No scoring system or clinical scale applied

    Measured: Baseline to week 96

  6. Change in CSF Neurofilament Light Chain (NfL) Levels From Baseline to Week 96

    CSF neurofilament light chain (NfL) concentrations were measured at baseline, Week 48, and Week 96 using immunoassay methods. NfL is reported as a continuous laboratory value. Results are presented as numerical measurements (mean and standard deviation). No clinical scoring system or scale applies

    Measured: Baseline to 96 weeks

  7. Change in CSF Soluble CD138 Levels From Baseline to Week 96

    Soluble CD138 concentrations in cerebrospinal fluid (CSF) were measured at baseline, Week 48, and Week 96 using immunoassay methods. Values are continuous laboratory measurements and are reported numerically (mean and standard deviation). No clinical scoring system or scale applies.

    Measured: Baseline to week 96

  8. Changes in CSF Cytokine and Chemokine Levels From Baseline to Week 96

    Cerebrospinal fluid (CSF) cytokines and chemokines were measured at baseline, Week 48, and Week 96 using immunoassays. Analytes included IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-5, IL-8, and TNF-α. Values are continuous laboratory measurements and are reported numerically (mean and standard deviation). No clinical scoring system or scale applies. Results for each analyte are presented in separate rows of the results table.

    Measured: Baseline to week 96

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 May 2024
  2. Study start1 Jul 2019
  3. Primary completion31 Jan 2024
  4. Study completion31 Jan 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06415864
Sponsor's protocol ID
262436
Status last verified
Feb 2026
First submitted
3 Apr 2024
Last updated
4 Feb 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Multiple Sclerosis, run by Queen Mary University of London at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Feb 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percent Change in Class-switched Memory B Cells From Baseline to Week 96 nh (time frame: Baseline to week 96). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2026.

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