Factors to Consider When Discontinuing MS Treatment

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The MD Magazine Peer Exchange "Modifying the Course of Multiple Sclerosis in New Ways: The Latest Advances in Treatment" features a distinguished panel of physician experts discussing key topics in multiple sclerosis (MS) research and management, including the latest insights into MS pathophysiology, new medication options and their application in clinical practice, and more.

This Peer Exchange is moderated by Paul Doghramji, MD, who is a family physician at Pottstown Memorial Medical Center in Pottstown, PA, and medical director of Health Services at Ursinus College, in Collegeville, PA.

The panelists are:

• Fred D. Lublin, MD, FAAN, FANA, the Saunders Family Professor of Neurology and director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, and co-chief editor of Multiple Sclerosis and Related Disorders at the Icahn School of Medicine at Mount Sinai
• Patricia K. Coyle, MD, professor of neurology, vice chair of Clinical Affairs, and director of MS Comprehensive Care Center
• Suhayl Dhib-Jalbut, MD, professor and chief of the Department of Neurology at Rutgers, Robert Wood Johnson Medical School

“The DMTs treat the relapsing form of MS, and right now, treatment is indefinite,” said Coyle. She said that it is uncertain if these therapies actually help patients with strictly progressive disease that is gradually worsening although being attack-free in years and with no gadolinium enhancement. In that case, she allows the patient’s preference to determine whether to continue treatment or stop.

Lublin pointed out that stopping a patient’s medication could lead to another attack, which carries a 50% chance of residual deficit. Basically, any time a patient notices a neurologic symptom, the panelists agreed that they should see their physician.