{
  "abstract": "Background\n\nDisease-modifying therapies (DMTs) are the mainstay of relapsing-remitting multiple sclerosis (RRMS) treatment. Their efficacy decreases with age, while risks such as infections increase. This study aimed to evaluate the safety and clinical outcomes of DMT discontinuation in patients with RRMS aged 55 years and older.Methods\n\nWe conducted a randomized clinical trial including 178 patients with RRMS aged ≥55 years, EDSS ≤3, and no relapses or MRI activity for at least 5 years. Patients were randomized to continue DMTs (n=89) or discontinue (n=89). Clinical relapses, EDSS scores, and MRI activity were assessed over 24 months.Results\n\nRelapses occurred in 9 (10.7%) patients in the continuation group and 12 patients (14.3%) in the discontinuation group (Risk Ratio [RR] = 1.33, 95% CI: 0.60 to 2.98; P=0.48). MRI activity was detected in 6 patients (7.1%) continuing DMTs and 9 (10.7%) patients who discontinued (RR = 1.50, 95% CI: 0.56 to 4.02; P=0.41). EDSS scores increased slightly in both groups during the first year. At 24 months, the mean EDSS was 1.59 (±0.74) in the continuation group and 1.36 (±0.74) in the discontinuation group, with no statistically significant difference between groups (mean difference = 0.23, 95% CI: -0.002 to 0.46; P=0.05).Conclusion\n\nIn patients aged ≥55 years with stable RRMS, discontinuation of DMTs did not significantly increase relapses, disability progression, or MRI activity compared with continuation. These findings suggest that DMT discontinuation may be a safe and reasonable option for selected older patients. Larger, multicenter studies with longer follow-ups are warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.",
    "Department of Epidemiology, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.",
    "Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sajjad Daneshyar"
    },
    {
      "affs": [
        0
      ],
      "name": "Masoud Ghiasian"
    },
    {
      "affs": [
        1
      ],
      "name": "Salman Khazaei"
    },
    {
      "affs": [
        2
      ],
      "name": "Kimia Alborzi"
    },
    {
      "affs": [
        0
      ],
      "name": "Maryam Ebadi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/62zd91h7qzhac.bib",
  "cited_by": 0,
  "doi": "10.22088/cjim.17.3.598",
  "fulltext_url": "https://europepmc.org/articles/PMC13690142",
  "id": "62zd91h7qzhac",
  "issns": [
    "2008-6164",
    "2008-6172"
  ],
  "landing_url": "https://europepmc.org/article/MED/42924257",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Multiple Sclerosis Research Studies"
    ]
  ],
  "openalex": "W7217838365",
  "pdf_url": "https://europepmc.org/articles/PMC13690142?pdf=render",
  "pmcid": "PMC13690142",
  "pmid": "42924257",
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/62zd91h7qzhac.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42924257",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42924257"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2734|Multiple Sclerosis Research Studies",
      "subfield": "general"
    }
  ],
  "title": "Disease-modifying therapies (DMTs) discontinuation in older relapsing-remitting multiple sclerosis (RRMS) patients with stable disease: Two-year randomized, controlled trial.",
  "title_text": "Disease-modifying therapies (DMTs) discontinuation in older relapsing-remitting multiple sclerosis (RRMS) patients with stable disease: Two-year randomized, controlled trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/62zd91h7qzhac",
  "venue": "Caspian journal of internal medicine",
  "versions": []
}