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Older Age Linked With Lower Risk of MS Activity After Stopping DMT
A patient’s age at discontinuation of first-line disease-modifying therapy (DMT) was a significant predictor of the return of inflammatory disease activity and relapse among patients with multiple sclerosis (MS), according to study results published online ahead of print in Multiple Sclerosis and Related Disorders.
“Higher age was not only associated with a lower occurrence of any inflammatory disease activity on magnetic resonance imaging (MRI), but also with a lower total number of new T2-lesions on MRI after DMT discontinuation,” researchers wrote. “Our study supports the consideration of discontinuation of first-line DMT in patients aged >55 years with long-term stable disease."
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The study included 130 patients from The Netherlands who were followed for a median 5 years after discontinuing first-line DMT with no intention of restarting. Among the patients, 87.7% had relapsing-remitting MS and 12.3% had secondary progressive MS. The most common reason for DMT discontinuation was medication side effects.
Some 60% of patients experienced disease activity, defined as MRI activity or one or more relapses, after discontinuing first-line DMT, according to the study. Specifically, 48.5% of patients had MRI activity, and 30.8% of patients had one or more relapses. Overall, 1 in 5 patients ended up restarting DMT.
When researchers looked at differences between patients who did and did not experience disease activity after stopping DMT, they found a lower likelihood of both MRI activity and relapse in older patients. Compared with patients younger than 45 years, odds ratios for MRI activity were 0.301 for those between 45 and 55 years and 0.296 for those older than 55 years. Similarly, odds ratios for risk of relapse were 0.495 for patients aged 45 through 55 and 0.081 for those aged 55 and older compared with younger patients.
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