Abstract General Information
Discontinuation of Disease Modifying Drugs in Elderly Patients with Multiple Sclerosis: A Retrospective Cohort Study
Disease modifying drugs (DMDs) have been shown to reduce relapses and improve survival in patients with multiple sclerosis (MS). However, the impact of discontinuing DMDs in elderly patients with MS, who may have a lower risk of relapse but a higher chance of experiencing DMD-related adverse events, remains unknown, as they are often excluded from clinical trials.
The aim of this study is to examine the impact of discontinuing DMDs on the clinical course of elderly patients with MS.
We conducted a retrospective observational study using data from MS patients aged over 55 years, from 2015 to 2022 in our service. Age, sex, disease duration, and previous DMD use were extracted from medical records. The primary outcome was the frequency of clinical / radiological disease activity after discontinuing DMDs. We compared patients who discontinued DMDs with those who did not, using Chi-Square and Mann-Whitney U tests in SPSS.
As of now, among 30 elderly MS patients, 19 (63.3%) discontinued DMDs and 11 (36.7%) maintained DMDs. After discontinuation, 6 (31.5%) of patients experienced clinical or radiographic disease activity. Patients who discontinued DMDs were significantly older than those who continued the therapy (69.95 vs. 65.00; p=0.047) and both groups had high median EDSS scores (6.5 vs 5.0), long disease duration (29.7 vs 22.7), and no participant who discontinued DMDs were on high-efficacy drugs. However, there were no significant differences in the proportion of female patients or disease duration.
The findings of this study suggest that discontinuing DMDs may result in up to one-third of elderly patients with MS experiencing disease activity. However, further research is needed to confirm these findings and identify prognostic factors that may be associated with successful discontinuation of treatment. The study is currently ongoing.
Graziella Aguiar Santos Faria, Tomás Fraga Ferreira da Silva, Natalia Nasser Ximenes, Paula Baleeiro Rodrigues Silva, Sara Terrim, Flavio Vieira Marques Filho, Samira Luísa Apóstolos-Pereira, Tarso Adoni, Guilherme Diogo Silva, Dagoberto Callegaro