Related Experiment Video
Updated: May 27, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
A Retrospective Analysis of Disease Modifying Drug Discontinuation in Patients with Multiple Sclerosis (S31.010)
Gnaneswari Karayi1, Natalia Quinones-Herrero2, Janice Martin3
1Brown University.
Objective:
To analyze patients with Multiple Sclerosis (MS) who discontinue disease modifying drugs (DMD) and experience disease activity (DA).
Background:
Although several studies have investigated outcomes related to DMD discontinuation, these results remain inconclusive. Our study aims to investigate the risk of MS disease activity after drug discontinuation.
Design/Methods:
This was an IRB-approved study. Retrospective analysis was conducted in patients seen at a single academic center from 2020-2023.
Results:
Out of 930 patients screened, 170 (18.2%) discontinued DMD. Mean age and EDSS were 60.3 years and 3.58, respectively. Patients discontinued DMD due to multiple reasons (side effects: 32%, MD suggestion: 34%, patient preference:17%, Insurance issues: 9%, Misc: 9%). A total of 27 patients (15.8%) developed DA (all had MRI activity, 13 with relapse) after discontinuation of DMD. The number of patients developing disease activity after discontinuing a specific DMD were as follows: fingolimod 7/12 (58%), natalizumab 7/23 (30%), B-cell depleting therapy 2/14 (14%), teriflunomide/dimethyl fumarate 4/31 (13%), IFN/glatiramer acetate 5/105 (5%). Mean age was 48 (only 4 patients were > 60 years) and EDDS was 2.8 (all < or =6.5).
Conclusions:
Patients who developed disease activity after discontinuing DMD were younger (mean age 48) compared to patients who remained with no disease activity (mean age 60) and had lower average EDSS scores (2.8 vs 3.58). Patients who discontinued fingolimod and natalizumab were at higher risk of disease activity after treatment discontinuation (58% and 30%, respectively). Finally, patients > 60 years and EDSS > 6 were at the lowest risk of disease activity after discontinuation. Disclosure: Miss Karayi has nothing to disclose. Dr. Quinones-Herrero has nothing to disclose. Janice martin has nothing to disclose. Dr. Chaudhry has nothing to disclose. The institution of Dr. Cahill has received research support from Roche / Genentech. Dr. Cahill has received publishing royalties from a publication relating to health care. Dr. Rizvi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serono Roche Bristol Myers . Dr. Rizvi has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Na.
Insights
Patients discontinuing multiple sclerosis (MS) disease-modifying drugs (DMDs) face a risk of disease activity, particularly younger individuals and those on fingolimod or natalizumab. Older patients or those with higher disability scores showed lower risk after stopping treatment.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Multiple Sclerosis (MS) disease-modifying drugs (DMDs) are crucial for managing the condition.
- Discontinuation of DMDs is common, but outcomes and risks of disease activity (DA) remain incompletely understood.
- Existing research on DMD discontinuation provides inconclusive evidence regarding the risk of subsequent MS activity.
Purpose of the Study:
- To analyze the risk of disease activity (DA) in patients with Multiple Sclerosis (MS) after discontinuing disease-modifying drugs (DMDs).
- To identify patient characteristics and specific DMDs associated with a higher risk of DA post-discontinuation.
Main Methods:
- Retrospective analysis of patients diagnosed with MS who discontinued DMDs.
- Data collected from a single academic center between 2020 and 2023.
- Evaluation of disease activity, including MRI findings and relapses, following DMD cessation.
Main Results:
- Out of 170 patients who discontinued DMDs, 15.8% (27 patients) experienced disease activity (DA).
- Higher rates of DA were observed in patients who discontinued fingolimod (58%) and natalizumab (30%).
- Younger patients (mean age 48) and those with lower EDSS scores (2.8) were more likely to develop DA.
Conclusions:
- Younger MS patients with lower disability scores are at increased risk of disease activity after DMD discontinuation.
- Fingolimod and natalizumab discontinuation are associated with a significantly higher risk of subsequent disease activity.
- Patients over 60 years old and with an EDSS score greater than 6 appear to have the lowest risk of DA post-discontinuation.
More Related Videos
Related Concept Videos
01:19Pharmacovigilance
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
01:15Assumptions of Survival Analysis
01:20Desensitization and Tachyphylaxis
01:12Analysis of Population Pharmacokinetic Data
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:23Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...