There is a move to discountinue people fromdrugs once they age over 50 years old, here they looked at people with older age onset of MS and they saw that if people were treated with higher efficacy treatments they reponded better than lower efficacy treatment, There are risk benefits balance for every agent but for some there is clearly benefit from not stopping
Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, Kalincik T, Roos I, Hodgkinson S, Lechner-Scott J, Lugaresi A, Weinstock-Guttman B, Ozakbas S, Surcinelli A, Foschi M, Boz C, Khoury SJ, Yamout B, Laureys G, Blanco Y, Skibina O, Kuhle J, John N, Alroughani R, Prevost J, Van Pesch V, Tomassini V, Prat A, Girard M, Terzi M, Shaygannejad V, Ampapa R, Gray O, Etemadifar M, Guimarães J, McCombe PA, Gerlach O, Solaro C, Butzkueven H, Zhu C, van der Walt A, Study Group M. Moderate-high efficacy disease-modifying therapies reduce relapse risk in late-onset multiple sclerosis.
Introduction: Late-onset multiple sclerosis (LOMS) now comprises over 10% of MS diagnoses in contemporary cohorts.….We aimed to establish the comparative effectiveness of moderate-high-efficacy versus low-efficacy DMTs in LOMS.
Methods: Using data from the MSBase registry, this multicentre cohort study included people with MS with symptom onset after age 50…..Primary outcomes were time to first relapse and annualised relapse rate (ARR). Secondary outcomes were 6-month confirmed disability progression (CDP), confirmed disability improvement (CDI)……
Results: Of 1032 participants, 472 received moderate-high-efficacy DMTs and 560 received low-efficacy DMTs……ARR was 0.06 for moderate-high-efficacy and 0.09 for low-efficacy DMTs, corresponding to an ARR ratio of 0.68 (95% CI 0.50 to 0.93, p=0.01)…Risk… for time to first relapse was 0.66 (95% CI 0.47 to 0.91, p=0.01) in favour of moderate-high-efficacy DMTs.Among 856 participants with adequate follow-up, 37% experienced CDP over a median of 4.43 year……
Conclusion: Moderate-high-efficacy DMTs reduced relapse risk in LOMS. Relapse activity was low. CDP was common…..the overall findings support the initial use of moderate-high-efficacy DMTs in LOMS.
Source: multiple-sclerosis-research.org