[P7.207] Stopping Disease Modifying Therapy in Progressive Multiple Sclerosis - A Prospective Study
Golden Valley, MN, USA
To review outcomes of persons with progressive multiple sclerosis who stopped disease modifying therapy
Current disease modifying therapies are not effective in progressive, MS. Guidelines are needed to decide when such therapies can be stopped safely.
A population of patients with progressive MS, being cared for in an MS specialty clinic, were either advised to stop their medication by their treating neurologist or chose to do so on their own. Follow up clinical exams and central nervous system MRIs were obtained on all patients at baseline and at varying times after stopping their disease modifying therapies.
Sixty-five patients were studied prospectively. Fifty-nine patients (Group A) stopped medication on the advice of their physician. Six patients stopped medication on their own (Group B). Four of the 59 patients in Group A (6.7%) had evidence of renewed inflammation on MRIs. Only one had an associated clinical change. All restarted treatment. None had sustained worsening of their MS. Differences between stable Group A patients and those with recurrent disease were significant for age (median age of stable patients: 62 years versus 53.5 years for relapsing patients; p=0.008) and time off disease modifying therapy (stable patients: 3.6 years; relapsing patients: 1.2 years; p=1.2x10-6). Differences for time on disease modifying therapy for these two populations were not significant (p=0.703). Four of the six patients in Group B had recurrent active disease (66.6%). The median age of Group B was 52 years, with a significant difference in ages between Group A and Group B (p=0.013). Age differences between relapsing Group A patients and Group B patients were not significant (p=0.929).
Over 90% of patients with progressive MS, advised to stop disease modifying therapy, remained stable. Patients younger than 60 years were at increased risk for recurrent acute inflammation. Therapy was restarted with no sustained worsening. Patients who discontinued therapy on their own had significantly higher relapse rates.
Study Supported by: None
Category - MS and CNS Inflammatory Disease: Clinical Science
Thursday, May 1, 2014 3:00 PM
P7: Poster Session VII: Multiple Sclerosis and CNS Inflammatory Diseases: Treatment (3:00 PM-6:30 PM)