New study says older MS patients can safely stop taking DMTs

A new small study has reported that people aged over 60 with multiple sclerosis (MS) and whose disease is stable can stop treatment without risking a relapse or worsening of disability.

Researchers said that over 60 it was only active lesions and an Expanded Disability Status Scale (EDSS) score of higher than three could significantly predict a bigger riak of progression or relapse.

A total of 35 people with MS took part in the study. They had a mean average age at diagnosis of 42.1 and 68% were female. When they were followed up on average 6.4 years later, 13 had discontinued the disease-modifying treatment (DMT) due to either disease progression or side effects. The median average age of discontinuation was 63. Most people who discontinued had secondary progressive MS.

At the beginning of the study, the patients who went on to either discontinue or continue their DMT were not significantly different in DMT exposure, disability score or demographics.

At the last follow-up, no difference was found between the groups in terms of rate of relapse or progression of disability after treatment discontinuation.

The discontinuation did not seem to affect clinical outcome and had no predicative value for worsening disability or relapse. However, having active inflammatory lesions found on an MRI scan at the age of 60 was an independent predictor of a higher relapse risk, and an EDSS score that’s higher than three at that age was a predictor of worsening disability risk.

“Retrospective data from this small cohort supports the notion that DMT discontinuation is not likely to affect long-term clinical outcomes in older stable MS patients,” the researchers said.

“Prospective studies on older MS patient cohorts, as well as clinical trials, should be conducted to offer clinicians a practical framework for DMT discontinuation and disease monitoring in this setting.”

Always speak to your doctor before considering changing or discontinuing any medication you have been prescribed.