Multiple Sclerosis Treatment Discontinuation from High-Efficacy Therapy

Recent studies have suggested that treatment discontinuation can be considered in patients with multiple sclerosis (MS) who are older and stable (NEJM JW Neurol Jul 28 2023 and Lancet Neurol 2023; 22:568). However, few patients recruited for discontinuation were on high-efficacy therapy (HET). In this study, investigators used a French MS registry to identify retrospectively 1857 patients older than 49 on HET.

Among 1452 patients who continued HET, 154 were propensity matched to 154 who discontinued HET. Time to relapse was significantly shorter among the HET-discontinued cohort, with differences by therapy: The hazard ratio for relapse compared with no discontinuation was 7.2 for natalizumab, 4.5 for fingolimod, and 1.1 (a nonsignificant di…