ActiveMSers Forums  

Go Back   ActiveMSers Forums > ActiveMSers.org Forums > General

 
 
Thread Tools Display Modes
Prev Previous Post   Next Post Next
  #1  
Old 04-02-2019, 02:04 PM
ActiveMSers's Avatar
ActiveMSers ActiveMSers is offline
Dave @ ActiveMSers
 
Join Date: Jun 2008
Location: Albuquerque, NM
Posts: 3,776
Default Discontinuation of disease-modifying therapy in patients with MS over age 60

Discontinuation of disease-modifying therapy in patients with multiple sclerosis over age 60

Le H Hua, Tracey H Fan, Devon Conway, ...
First Published March 20, 2018
Research Article
https://doi.org/10.1177/1352458518765656

Abstract

Background:
The risk–benefit ratio of continuing immunomodulating disease-modifying therapy (DMT) in older multiple sclerosis (MS) patients is unknown.

Objective:
To evaluate clinical and patient-reported outcomes after stopping DMT in older MS patients.

Methods:
Retrospective, observational study identifying patients from our MS clinics who were aged over 60 and on DMT > 2 years. Cause-specific Cox proportional hazards regression modeled time to discontinuation and time to reinitiation of therapy. Pre- and post-discontinuation comparisons of Performance Scales (PS), Timed 25-Foot Walk, and Patient Health Questionnaire-9 (PHQ9) were analyzed using linear mixed models.

Results:
A total of 600 patients were included, 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. Providers initiated discontinuation more than patients (68.0%). Only one clinical relapse occurred in discontinuers. A proportion (10.7%) reinitiated DMT. Provider-initiated discontinuers restarted less often (hazard ratio (HR): 0.34; 95% confidence interval (CI): 0.12–0.9). In discontinuers, relapsing-remitting patients had lower PS on average than primary progressive. Provider-initiated discontinuation was associated with lower PS than patient- initiated discontinuation. PHQ9 scores appeared higher in those stopping intravenous (IV) therapies than interferons. Lower PS and PHQ9 indicate better outcomes.

Conclusion:
Most patients over age 60, who discontinued DMT, remained off DMT. This study provides real-world data that may guide clinicians considering discontinuing DMT.
__________________
Dave Bexfield
ActiveMSers
Reply With Quote
 

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -4. The time now is 12:58 PM.


Powered by vBulletin® Version 3.7.0
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
ActiveMSers