High Risk for Progression in Late-Onset Multiple Sclerosis

Patients with late-onset multiple sclerosis (LOMS) (starting at age 50 or later) increasingly are recognized as a high-risk population who are often undertreated (NEJM JW Neurol Jan 2 2024 and Ann Neurol 2024; 95:471; NEJM JW Neurol Dec 11 2023 and JAMA Neurol 2024; 81:50). To compare patient characteristics, disease-modifying therapy use, and clinical outcomes in patients with LOMS and adult-onset MS (at ages 18 through 49), investigators analyzed Swedish MS registry data from 2001 through 2018.

Among 8739 patients with MS, 12% had LOMS. Patients with LOMS were more likely to have progressive disease at onset, less frequently treated with disease-modifying therapies, less likely to have received high-efficacy therapies, and more likely to r…