Should treatment be continued when MS patients get older and disease is less active?



Data on the scientific question whether mid-life or older patients with MS should continue treatment after a period of clinical stability or after a certain age threshold are not yet available from randomized controlled trials [ongoing studies include DISCO-MS trial (NCT03073603) and STOP-I-SEP (NCT 03653273)]. Registry data suggest that after stopping therapy, the risk of a relapse may remain unaffected [1,2], but patients may have a higher likelihood of disability progression [1], or of reaching earlier disability milestones like EDSS 6 [2]. Data, however, are inconsistent. The ECTRIMS/EAN recommendations propose MS therapy be continued if a patient is stable (clinically and on MRI) and shows no safety or tolerability issues [3].



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