ChariotMS - Cladribine to Halt Deterioration in People With Advanced Multiple Sclerosis

This trial is open to adults aged 18 and older who have been diagnosed with advanced or progressive MS. Participants will generally have higher levels of mobility disability (such as needing a wheelchair to get around), but must still have enough use in at least one hand to complete a simple pegboard movement test within three minutes. Doctors also need to see that your arm or hand function has worsened over the past two years.

To be eligible, you must also be up to date with routine NHS cancer screenings that apply to you, such as cervical, breast, or bowel screening. You will need to weigh at least 40 kg (around 6 stone 4 lbs).

You will not be able to join if you have certain other health conditions, such as severe heart, kidney, or liver disease, uncontrolled diabetes, or a history of stroke. You cannot take part if you have an active long-term infection (such as tuberculosis, hepatitis, or HIV) or a current cancer. Pregnant and breastfeeding women cannot participate, and all participants who could start a pregnancy must agree to use reliable contraception during and after the study.

Taking part in ChariotMS lasts for about two years. If you join, you will be randomly placed into one of two groups: one group takes cladribine tablets, and the other takes matching placebo tablets. Neither you nor your doctor will know which group you are in during the trial.

The tablets are taken in short courses: a few days of pills at the start of year one, a few days a month later, and the same short schedule repeated in year two. Throughout the two years, you will attend regular hospital appointments. During these visits, the research team will check your health, take routine blood tests, and measure your arm and hand coordination using a simple peg test. Doctors will closely track any side effects or changes in your symptoms.