Multiple sclerosis (MS) is a chronic disease whose pathogenesis is based on autoimmune neuroinflammatory and neurodegenerative components. The goal of therapy of MS is to reduce the risk of exacerbations and progression of the disease. In recent years, treatment options have expanded significantly with the advent of a greater number of highly effective drugs that alter the course of MS (disease-modyfyung therapies, DMTs) and in the context of the development of a new direction – immune reconstitution therapy (IRT). IRT has a number of advantages, including short treatment courses with long-term effects on immune mechanisms. Cladribine tablets are a selective, highly effective oral form of IRT for MS patients with exacerbations that targets lymphocytes while preserving innate immune cells. Given the increasing number of patients receiving cladribine therapy, questions are increasingly being raised about further tactics for managing these patients, particularly in cases of persistent disease activity despite ongoing pathogenetic therapy. In this review, we publish the results of the consensus opinion of international experts on the analysis of long-term experience with cladribine.