- March 23, 2018
- Posted by: PharmaScroll
- Category:
The risk–benefit ratio of continuing immunomodulating disease-modifying therapy (DMT) in older multiple sclerosis (MS) patients is unknown. Very recently a study was conducted to evaluate clinical and patient-reported outcomes after stopping DMT in older MS patients and was published on March 20th, 2018.
The study was a retrospective, observational study identifying patients from MS clinics who were aged over 60 and on DMT for more than 2 years. The patients were measured and analysed, Pre- and post-discontinuation of therapies, on the parameters of Performance Scales (PS), Timed 25-Foot Walk, and Patient Health Questionnaire-9 (PHQ9) using linear mixed models.
Outcomes of the study:
A total of 600 patients were included in the study, with 178 (29.7%) discontinuing. Discontinuers were 2.2 years older, had 3.2 years longer disease duration, and 1.6 years lesser treatment exposure. It was observed during the study that the Providers initiated discontinuations were more than patients (68.0%). Also only one clinical relapse was observed in the discontinuers. There were around 10.7% of the discontinuers who reinitiated their DMT. However, Provider-initiated discontinuers restarted less often (hazard ratio (HR): 0.34; 95% confidence interval (CI): 0.12–0.9) as compared to patient requested discontinuers. Additionally, lower PS was observed, in the provider-initiated discontinuations as compared to the patient requested discontinuations, indicating better disease outcomes. Also, lower PS was observed, on an average, in the RRMS patients as compared to the PPMS patients. PHQ9 scores appeared higher in those stopping intravenous (IV) therapies than interferons.
Conclusion:
The study has tried to establish clinical and patient reported outcomes post discontinuation of therapies in older MS patients. These clinical attributes can be further assessed through advanced studies and be used by physicians in making a treatment discontinuation decision.
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News Source: http://journals.sagepub.com
Image Source: https://www.genengnews.com/the-lists/top-10-multiple-sclerosis-drugs/77900039