Hans-Peter Hartung1, Sven G Meuth, Deborah M Miller, Giancarlo Comi. 1. Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany Brain and Mind Centre, University of Sydney, Camperdown Department of Neurology, Medical University of Vienna, Wien, Austria Mellen Center Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA Università Vita Salute San Raffaele, Multiple Sclerosis Centre, Hospital of Gallarate, Italy.
Abstract
PURPOSE OF REVIEW: To assess the reasons for considering discontinuation of disease-modifying therapies (DMTs)in patients with multiple sclerosis (MS). Relevant aspects of the natural history, pathology, and immunology are analyzed. RECENT FINDINGS: A number of retrospective observational studies in aggregate indicate that stopping DMTs may be attempted in older individuals with stable disease. Prognostic factors have been identified informing about the risk of recurrence of disease activity after DMT discontinuation. SUMMARY: Several clinical scenarios provide a rationale to stop DMTs in people with MS. Cumulative evidence has been gathered recently allowing us to more precisely weigh the risks against the benefits. This information aids in the decision process.
PURPOSE OF REVIEW: To assess the reasons for considering discontinuation of disease-modifying therapies (DMTs)in patients with multiple sclerosis (MS). Relevant aspects of the natural history, pathology, and immunology are analyzed. RECENT FINDINGS: A number of retrospective observational studies in aggregate indicate that stopping DMTs may be attempted in older individuals with stable disease. Prognostic factors have been identified informing about the risk of recurrence of disease activity after DMT discontinuation. SUMMARY: Several clinical scenarios provide a rationale to stop DMTs in people with MS. Cumulative evidence has been gathered recently allowing us to more precisely weigh the risks against the benefits. This information aids in the decision process.
Authors: Jennifer H Yang; Torge Rempe; Natalie Whitmire; Anastasie Dunn-Pirio; Jennifer S Graves Journal: Front Neurol Date: 2022-06-03 Impact factor: 4.086
Authors: Massimiliano Mirabella; Pietro Annovazzi; Wallace Brownlee; Jeffrey A Cohen; Christoph Kleinschnitz; Christian Wolf Journal: Front Neurol Date: 2022-04-15 Impact factor: 4.086