Discontinuing Disease-Modifying Therapy in Older Patients With MS: John Corboy, MD

WATCH TIME: 8 minutes | Captions are auto-generated and may contain errors.

"It’s become clear that older individuals, perhaps over the age of 60, and those who haven’t had recent disease activity, with either an MRI scan change or a relapse, are the ones who are likely to have the best outcome should they choose a trial off of medication.”

Disease-modifying therapy (DMT) discontinuation in multiple sclerosis (MS) has emerged as a key clinical question as the treated population ages and long-term safety, efficacy, and cost considerations come into sharper focus. Growing data from observational cohorts and controlled trials suggest that, for select older patients with stable disease, the balance of benefit and risk may shift over time, raising uncertainty about when and how to safely pause or stop therapy. At the same time, clinicians must interpret low-level MRI activity, weigh relapse risk, and address progression that may be only partially responsive or unresponsive to currently available DMTs.

Recently, John Corboy, MD, professor of neurology at the University of Colorado, presented on DMTs in MS in a session at the 2026 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 27-29, Charlotte, North Carolina. In his talk, Corboy reviewed evidence from randomized controlled trials, including DISCOMS, as well as emulation and observational studies that examine outcomes following DMT discontinuation in older, clinically and radiographically stable patients. Throughout the presentation, Corboy highlighted the importance of age, disease duration, time since last activity, and DMT mechanism of action in informing individualized decisions.

In a follow-up interview with NeurologyLive^®, Corboy expanded on key themes from his presentation, focusing on how emerging evidence is reshaping clinicians’ discussions about DMT withdrawal with older adults with MS. He addressed which clinical factors may identify appropriate candidates for discontinuation and the current understanding of disability progression in stable patients who stop therapy. He also noted priority questions for future research, including long-term outcomes, differences between specific agents, and de-escalation strategies for commonly used therapies such as CD20-directed monoclonal antibodies.

Click here for more coverage of CMSC 2026.

REFERENCES
1. Corboy J. Disease Modifying Therapy Discontinuation in MS: DISCOMS and other Controlled Trials. Presented at: 2026 CMSC Annual Meeting; May 27-29; Charlotte, North Carolina.