Treatment withdrawal in relapsing-remitting multiple sclerosis: a retrospective cohort study

Abstract

Background: To investigate the effect of drug withdrawal on the course of relapsing-remitting multiple sclerosis (RR-MS).

Methods: An observational cohort retrospective study was performed to compare the time to relapse of patients who discontinued disease-modifying therapy (1a or 1b beta-interferons or glatiramer acetate) with the patients who did not. One hundred and twenty-eight RR-MS patients were investigated using a time-dependent approach.

Results: Over a median follow-up of 108 months, 60 patients discontinued treatment and 89 relapses were observed. The time to relapse was shorter in patients who discontinued treatment compared with those who did not (P < 0.001), median times being 31.1 months (95% confidence interval 10.4-50.8) and 85.8 months (95% confidence interval 58.6-106.3), respectively, whilst the baseline covariates (gender, Expanded Disability Status Scale at diagnosis) did not significantly affect the prognosis.

Conclusions: It was found that stopping treatment strongly reduces the time to relapse and this information may be useful in patient management.

Keywords: multiple sclerosis; treatment withdrawal.