Staff neurologist, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic
The neurologist at Cleveland Clinic discusses the clinical considerations included in the decision to stop treatment of MS in patients with progressive disease.
“At this point, we don’t have any evidence to suggest that a relapse in an older patient is more injurious, more problematic, or more likely to leave permanent injury than in a younger patient.”
It is well known that multiple sclerosis (MS) disease activity gradually decreases over time as patients progressively get older, but what that means for ongoing disease treatment is still not well understood.
Attempts to better understand if MS therapy should be discontinued — and when—are ongoing, including a randomized study being led by John. R. Corboy, MD, out of the University of Colorado. Corboy and colleagues are enrolling patients aged 55 and older who have been on stable MS treatment for at least 5 years to examine whether withdrawing treatment results in disease relapse, and what markers might be indicative of the disease returning.
In an interview with NeurologyLive, Robert Fox, MD, a neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic, discussed concerns that surround this clinical decision, including the possibility that disease relapse after withdrawing therapy may be worse than the original MS disease course experienced by the patient. Fox noted that the current understanding of MS disease activity suggests that disease relapse in older patients might actually be less injurious than what is experienced in younger patients which more active disease, but evidence remains inconclusive.