Pendulum keeps swinging on risks from drug discontinuation
by Judy George, Contributing Writer, MedPage Today
March 04, 2019
DALLAS — Patients with stable relapsing-remitting multiple sclerosis (MS) who stopped disease-modifying therapies (DMTs) showed similar times to relapses, inflammatory events, and disability progression as stable patients who remained on treatment, according to a small observational study presented here.
In addition, patients who were older — ages >45 — when they stopped treatment appeared to have better outcomes, reported Hajime Yano, MD, of Brigham and Women’s Hospital in Boston, and colleagues, at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum.
“There’s been a lot of interest in the last 5 years about this issue,” said co-author Tanuja Chitnis, MD, also of Brigham and Women’s Hospital, in an interview with MedPage Today. “There are questions about how safe it is to treat long-term with DMTs.”
“This data suggests that younger age goes along with more inflammatory disease activity and that is the critical group that needs to be treated with DMTs,” she added. “And potentially after the age of 45 or 50, in stable patients, there may be opportunities to stop or step down DMTs.”
While other studies have looked at discontinuing DMTs, a key strength of this research is the MRI data, Yano said. “Our study includes MRI activity as an inclusion and also as outcome measures,” he told MedPage Today.
In this analysis, Yano and colleagues identified 70 relapsing-remitting MS patients who discontinued DMTs in the CLIMB (Comprehensive Longitudinal Investigation of MS at the Brigham and Women’s Hospital) cohort. Patients had been treated for ≥2 years and had no clinical and radiological relapses — including no gadolinium-enhancing (Gd+) or new T2 lesions, or T2 lesion enlargement — for ≥2 years before discontinuing. Most patients were on glatiramer acetate (Copaxone; 44.3%) or interferon beta-1a (Rebif; 41.4%).
At baseline, patients were an average of age 45, a mean disease duration of about 12.5 years, and been receiving treatment for an average of 6 years. Most (87%) were female.
The researchers matched this group with 70 patients who remained on treatment, and looked for differences between the two groups in time to clinical relapse, MRI event, disability progression, and any inflammatory event (either clinical relapse or MRI event).
Compared with those who continued treatment, patients who discontinued DMTs had similar outcomes in time to:
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by Judy George, Contributing Writer, MedPage Today
March 04, 2019
DALLAS — Patients with stable relapsing-remitting multiple sclerosis (MS) who stopped disease-modifying therapies (DMTs) showed similar times to relapses, inflammatory events, and disability progression as stable patients who remained on treatment, according to a small observational study presented here.
In addition, patients who were older — ages >45 — when they stopped treatment appeared to have better outcomes, reported Hajime Yano, MD, of Brigham and Women’s Hospital in Boston, and colleagues, at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) forum.
“There’s been a lot of interest in the last 5 years about this issue,” said co-author Tanuja Chitnis, MD, also of Brigham and Women’s Hospital, in an interview with MedPage Today. “There are questions about how safe it is to treat long-term with DMTs.”
“This data suggests that younger age goes along with more inflammatory disease activity and that is the critical group that needs to be treated with DMTs,” she added. “And potentially after the age of 45 or 50, in stable patients, there may be opportunities to stop or step down DMTs.”
While other studies have looked at discontinuing DMTs, a key strength of this research is the MRI data, Yano said. “Our study includes MRI activity as an inclusion and also as outcome measures,” he told MedPage Today.
In this analysis, Yano and colleagues identified 70 relapsing-remitting MS patients who discontinued DMTs in the CLIMB (Comprehensive Longitudinal Investigation of MS at the Brigham and Women’s Hospital) cohort. Patients had been treated for ≥2 years and had no clinical and radiological relapses — including no gadolinium-enhancing (Gd+) or new T2 lesions, or T2 lesion enlargement — for ≥2 years before discontinuing. Most patients were on glatiramer acetate (Copaxone; 44.3%) or interferon beta-1a (Rebif; 41.4%).
At baseline, patients were an average of age 45, a mean disease duration of about 12.5 years, and been receiving treatment for an average of 6 years. Most (87%) were female.
The researchers matched this group with 70 patients who remained on treatment, and looked for differences between the two groups in time to clinical relapse, MRI event, disability progression, and any inflammatory event (either clinical relapse or MRI event).
Compared with those who continued treatment, patients who discontinued DMTs had similar outcomes in time to:
CLICK here to continue reading
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