Episode 20: Discontinuing DMTs in Patients with Stable Relapsing-remitting MS: When and How?

Long term use of disease modifying treatments (DMTs) poses challenges in terms of safety and pharmacoeconomics, while preventing disability progression. As such, there is an ongoing debate on how long disease modifying treatments should be continued and if discontinuation should be considered in stable multiple sclerosis.

In this episode, Alan Thompson, Editor in Chief of the MS Journal, speaks with Gilles Edan, Professor of Clinical Neurology and Chair of the Department of Neurosciences, University Hospital of Rennes; and Eva Strijbis, Neurologist at the Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers.

Studies referenced in this episode:

Ahrweiller, Kevin et al. “Decreasing impact of late relapses on disability worsening in secondary progressive multiple sclerosis.” Multiple Sclerosis, vol. 26, no.8, 2020, pp. 924-935. doi:10.1177/1352458519848090

Corboy, John R. et al. “Risk of new disease activity in patients with multiple sclerosis who continue or discontinue disease-modifying therapies (DISCOMS): A multicentre, randomised, single-blind, phase 4, non-inferiority trial.” The Lancet Neurology, vol. 22, no.7, 2023, pp. 568-577. doi:10.1016/S1474-4422(23)00154-0

Edan, Gilles, and Emmanuelle Le Page. “Escalation Versus Induction/High-Efficacy Treatment Strategies for Relapsing Multiple Sclerosis: Which is Best for Patients?.” Drugs, vol. 83, no.15, 2023, pp. 1351-1363. doi:10.1007/s40265-023-01942-0

Lefort, M. et al. “Ten-year follow-up after mitoxantrone induction for early highly active relapsing-remitting multiple sclerosis: An observational study of 100 consecutive patients.” Revue Neurologique, vol. 178, no.6, 2022, pp. 569-579. doi:10.1016/j.neurol.2021.11.014

Tremlett, H. et al. “Impact of multiple sclerosis relapses on progression diminishes with time.” Neurology, vol. 73, no. 20, 2009, pp. 1616-23. doi:10.1212/WNL.0b013e3181c1e44f