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Updated: Jan 13, 2026
10:46
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
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Moderate-high efficacy disease-modifying therapies reduce relapse risk in late-onset multiple sclerosis
Yi Chao Foong1,2, Daniel Merlo3, Melissa Gresle4,5
1University of Tasmania Menzies Institute for Medical Research, Hobart, Tasmania, Australia.
Journal of Neurology, Neurosurgery, and Psychiatry
|October 29, 2025
Summary
Moderate-to-high efficacy disease-modifying therapies (DMTs) significantly reduce relapse risk in late-onset multiple sclerosis (LOMS). While disability progression was common, these therapies show promise for initial LOMS treatment.
Area of Science:
- Neurology
- Immunology
- Clinical Trials
Background:
- Late-onset multiple sclerosis (LOMS), diagnosed after age 50, represents a growing proportion of new multiple sclerosis (MS) cases.
- The comparative effectiveness of different disease-modifying therapies (DMTs) in LOMS remains incompletely understood.
- This study addresses the need for evidence-based treatment guidelines for LOMS patients.
Purpose of the Study:
- To compare the effectiveness of moderate-to-high efficacy DMTs versus low-efficacy DMTs in patients with LOMS.
- To evaluate the impact of DMTs on relapse rates, disability progression, and other key clinical outcomes in LOMS.
- To inform clinical decision-making regarding initial DMT selection for LOMS.
Main Methods:
- A multicentre cohort study utilizing data from the MSBase registry.
- Inclusion criteria: individuals diagnosed with MS with symptom onset after age 50.
- Inverse-probability-treatment-weighting (IPTW) was used for covariate balancing; primary outcomes included time to first relapse and annualized relapse rate (ARR).
Main Results:
- Moderate-to-high efficacy DMTs were associated with a significantly lower ARR (0.06 vs. 0.09, ARR ratio 0.68, p=0.01) and reduced time to first relapse (HR 0.66, p=0.01).
- 37% of participants experienced 6-month confirmed disability progression (CDP) over a median of 4.43 years, primarily driven by progression independent of relapse activity (PIRA).
- While trends favored moderate-to-high efficacy DMTs for time to CDP (HR 0.78, p=0.08) and relapse-associated worsening (RAW) (HR 0.69, p=0.31), these did not reach statistical significance.
Conclusions:
- Moderate-to-high efficacy DMTs are effective in reducing relapse risk for individuals with LOMS.
- Despite low overall relapse activity, confirmed disability progression is common in LOMS, largely due to PIRA.
- The findings support the use of moderate-to-high efficacy DMTs as an initial treatment strategy for LOMS.
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