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DISCOntinuation of disease-modifying therapies in MS: The DISCOMS extension trial

John R Corboy1, Robert J Fox2, Gary Cutter3

  • 1Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 21, 2025
PubMed
Abstract

Insights

Discontinuing disease-modifying therapies (DMTs) for multiple sclerosis (MS) in stable patients did not show non-inferiority to continuing DMTs. New MS disease activity was rare in both groups during the extension study.

Area of Science:

  • Neurology
  • Clinical Trials
  • Immunology

Background:

  • The DISCOMS trial investigated discontinuing disease-modifying therapies (DMTs) in stable multiple sclerosis (MS) patients.
  • The primary trial did not demonstrate non-inferiority of discontinuing DMTs compared to continuing them.
  • New disease activity observed was primarily limited to new brain MRI lesions without clinical symptoms.

Purpose of the Study:

  • To report findings from the extension study of the DISCOMS trial.
  • To assess long-term outcomes of discontinuing DMTs in MS patients.

Main Methods:

  • Patients who completed the DISCOMS trial and met specific criteria were enrolled in the extension study.
  • Participants were followed for at least 30 months post-enrollment, with brain MRI assessments.
  • The primary endpoint was time to relapse or new brain MRI activity.

Main Results:

  • Mean follow-up was 40 months.
  • No relapses occurred; new brain MRI lesions were infrequent (1/30 continuers, 2/44 discontinuers).
  • Time to a disease event was significantly shorter for patients who discontinued DMTs (p=0.043).

Conclusions:

  • Time to new MS activity remained shorter in the DMT discontinuation group during the extension study.
  • Relapses were absent, and new brain MRI lesions were rare in both groups.
  • The findings suggest a potential difference in disease activity progression between continuing and discontinuing DMTs, despite overall low event rates.
Keywords:
Multiple sclerosisagediscontinuationdisease-modifying therapyextension

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