A clinical study is to look at whether older people with MS can stop using disease modifying therapies (DMTs). The proposal has left me in two minds.
The idea seems to be that those who have not any relapses for a few years could quit the treatment.
I will be 65 this week and so have reached the ‘older people’ category. However, despite receiving a diagnosis of MS 15½ years ago, I have never taken any of the DMTs.
So, on one hand, I welcome the opportunity for anyone to give up DMTs, with their associated side effects. But, on the other, I am not happy that this could possibly be a step on the way to saying that such treatments do not benefit older people.
The study, that is now enrolling people with progressive or relapsing multiple sclerosis, was unveiled at the recent joint ECTRIMS-ACTRIMS meeting in Paris. It was part of a presentation made by John Corboy, of the University of Colorado School of Medicine. He believes older MS patients could end their treatment.
DMTs: Relapses more common in younger people
His presentation, “Disease modifying therapy in the aging multiple sclerosis patient”, highlighted data that shows MS relapses are more common in younger people, and are less frequent as they get older.
This is supported by the fact that young people show plenty of inflammatory lesions, while those age 50 or older often have no signs of inflammation. I can identify with that as my last MRI scan, a year ago, showed my lesions were all inactive.
Corbyn said that clinical trials show better effects of DMT use in the young, especially those aged under 40, but that most trials have included those older than 55. That being the case, existing data does suggest that older patients with an extended period of no disease activity could stop taking DMTs.
The new study, called DISCOMS (NCT03073603), is recruitng up to 300 patients, at 15 clinics across the US. Patients need to be at least 55, and be free of relapses and MRI changes for at least five years while on any of the 14 approved DMTs. You can find out more about enrollment here.
The trial is run until 2021, but the first data is expected to be available a year or so earlier.
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50shadesofsun.com is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.