Most patients with multiple sclerosis (MS) aged >60 who discontinued disease modifying therapy (DMT) remained off treatment, a recent study found. Among the outcomes, only the European Quality of Life 5 Dimensions (EQ-5D) index demonstrated significant differences over time, with continuers having lower quality of life scores compared to discontinuers before discontinuation (DBD). Researchers conducted a retrospective, observational study in which they identified patients from MS clinics aged ≥60 years who had been on DMT ≥2 years. They compared outcome evolution over time among treatment groups (continuers, DBD), and discontinuers after discontinuation [DAD]), by creating separate mixed-effects linear regression models that included an interaction term between time from age 60 and treatment group to study outcome trajectories. They found:
- 178 of 600 patients discontinued DMT, and 89.3% (n=159) of those who discontinued remained off DMT.
- Only the EQ-5D mixed-effects linear regression model with the interaction term was statistically significant.
- The slope relating time to EQ-5D was significantly different when comparing continuers to DBD.
- The slopes were not significantly different when comparing continuers to DAD, or when comparing the before and after discontinuation slopes among the discontinuers.
Hua LH, Harris H, Conway D, Thompson NR. Changes in patient-reported outcomes between continuers and discontinuers of disease modifying therapy in patients with multiple sclerosis over age 60. [Published online ahead of print March 1, 2019]. Mult Scler Relat Disord . doi:10.1016/j.msard.2019.02.028.