Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis

Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis Publisher Pubmed

Foong YC ; Merlo D ; Gresle M ; Buzzard K ; Horakova D ; Havrdova EK ; Kalincik T ; Roos I ; Hodgkinson S ; Lechnerscott J ; Lugaresi A ; Weinstockguttman B ; Ozakbas S ; Surcinelli A Show All Authors

Foong YC
Merlo D
Gresle M
Buzzard K
Horakova D
Havrdova EK
Kalincik T
Roos I
Hodgkinson S
Lechnerscott J
Lugaresi A
Weinstockguttman B
Ozakbas S
Surcinelli A
Foschi M
Boz C
Khoury SJ
Yamout B
Laureys G
Blanco Y
Skibina O
Kuhle J
John N
Alroughani R
Prevost J
Van Pesch V
Tomassini V
Prat A
Girard M
Terzi M
Shaygannejad V
Ampapa R
Gray O
Etemadifar M
Guimaraes J
Mccombe PA
Gerlach O
Solaro C
Butzkueven H
Zhu C
Van Der Walt A
Study Group M

Source: Journal of Neurology, Neurosurgery and Psychiatry Published:2025

Abstract

Introduction Late-onset multiple sclerosis (LOMS) now comprises over 10% of MS diagnoses in contemporary cohorts. The effectiveness of disease-modifying therapies (DMTs) in LOMS is unclear. We aimed to establish the comparative effectiveness of moderate-high-efficacy versus low-efficacy DMTs in LOMS. Methods Using data from the MSBase registry, this multicentre cohort study included people with MS with symptom onset after age 50. Covariates were balanced using inverse-probability-treatment-weighting (IPTW). Primary outcomes were time to first relapse and annualised relapse rate (ARR). Secondary outcomes were 6-month confirmed disability progression (CDP), confirmed disability improvement (CDI), relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA). Results Of 1032 participants, 472 received moderate-high-efficacy DMTs and 560 received low-efficacy DMTs. IPTW-weighted ARR was 0.06 for moderate-high-efficacy and 0.09 for low-efficacy DMTs, corresponding to an ARR ratio of 0.68 (95% CI 0.50 to 0.93, p=0.01). HR for time to first relapse was 0.66 (95% CI 0.47 to 0.91, p=0.01) in favour of moderate-high-efficacy DMTs. Among 856 participants with adequate follow-up, 37% experienced CDP over a median of 4.43 years, with most events (83.6%) attributable to PIRA. The HR for time to CDP was 0.78 (p=0.08) and RAW was 0.69 (p=0.31) in favour of moderate-high-efficacy DMTs, though neither reached statistical significance. There was no difference in CDI or PIRA. Conclusion Moderate-high-efficacy DMTs reduced relapse risk in LOMS. Relapse activity was low. CDP was common and driven by PIRA. Although the CDP and RAW results did not reach statistical significance, the overall findings support the initial use of moderate-high-efficacy DMTs in LOMS. © 2025 Author(s) (or their employer(s)).

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Vahid Shaygannejad (6)

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Style	Citing Format
MLA	Foong YC, et al.. "Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis." Journal of Neurology, Neurosurgery and Psychiatry, vol. , no. , 2025, pp. -.
APA	Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, Kalincik T, Roos I, Hodgkinson S, Lechnerscott J, Lugaresi A, Weinstockguttman B, Ozakbas S, Surcinelli A, Foschi M, Boz C, Khoury SJ, Yamout B, Laureys G, ... Study Group M (2025). Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis. Journal of Neurology, Neurosurgery and Psychiatry, (), -.
Chicago	Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, Kalincik T, et al.. "Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis." Journal of Neurology, Neurosurgery and Psychiatry , no. (2025): -.
Harvard	Foong YC et al. (2025) 'Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis', Journal of Neurology, Neurosurgery and Psychiatry, (), pp. -.
Vancouver	Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, et al.. Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis. Journal of Neurology, Neurosurgery and Psychiatry. 2025;():-.
BibTex	@article{ author = {Foong YC and Merlo D and Gresle M and Buzzard K and Horakova D and Havrdova EK and Kalincik T and Roos I and Hodgkinson S and Lechnerscott J and Lugaresi A and Weinstockguttman B and Ozakbas S and Surcinelli A and Foschi M and Boz C and Khoury SJ and Yamout B and Laureys G and Blanco Y and Skibina O and Kuhle J and John N and Alroughani R and Prevost J and Van Pesch V and Tomassini V and Prat A and Girard M and Terzi M and Shaygannejad V and Ampapa R and Gray O and Etemadifar M and Guimaraes J and Mccombe PA and Gerlach O and Solaro C and Butzkueven H and Zhu C and Van Der Walt A and Study Group M}, title = {Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis}, journal = {Journal of Neurology, Neurosurgery and Psychiatry}, volume = {}, number = {}, pages = {-}, year = {2025} }
RIS	TY - JOUR AU - Foong YC AU - Merlo D AU - Gresle M AU - Buzzard K AU - Horakova D AU - Havrdova EK AU - Kalincik T AU - Roos I AU - Hodgkinson S AU - Lechnerscott J AU - Lugaresi A AU - Weinstockguttman B AU - Ozakbas S AU - Surcinelli A AU - Foschi M AU - Boz C AU - Khoury SJ AU - Yamout B AU - Laureys G AU - Blanco Y AU - Skibina O AU - Kuhle J AU - John N AU - Alroughani R AU - Prevost J AU - Van Pesch V AU - Tomassini V AU - Prat A AU - Girard M AU - Terzi M AU - Shaygannejad V AU - Ampapa R AU - Gray O AU - Etemadifar M AU - Guimaraes J AU - Mccombe PA AU - Gerlach O AU - Solaro C AU - Butzkueven H AU - Zhu C AU - Van Der Walt A AU - Study Group M TI - Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis JO - Journal of Neurology, Neurosurgery and Psychiatry VL - IS - SP - EP - PY - 2025 ER -

Style

Citing Format

MLA

Foong YC, et al.. "Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis." Journal of Neurology, Neurosurgery and Psychiatry, vol. , no. , 2025, pp. -.

APA

Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, Kalincik T, Roos I, Hodgkinson S, Lechnerscott J, Lugaresi A, Weinstockguttman B, Ozakbas S, Surcinelli A, Foschi M, Boz C, Khoury SJ, Yamout B, Laureys G, ... Study Group M (2025). Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis. Journal of Neurology, Neurosurgery and Psychiatry, (), -.

Chicago

Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, Kalincik T, et al.. "Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis." Journal of Neurology, Neurosurgery and Psychiatry , no. (2025): -.

Harvard

Foong YC et al. (2025) 'Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis', Journal of Neurology, Neurosurgery and Psychiatry, (), pp. -.

Vancouver

Foong YC, Merlo D, Gresle M, Buzzard K, Horakova D, Havrdova EK, et al.. Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis. Journal of Neurology, Neurosurgery and Psychiatry. 2025;():-.

BibTex

@article{ author = {Foong YC and Merlo D and Gresle M and Buzzard K and Horakova D and Havrdova EK and Kalincik T and Roos I and Hodgkinson S and Lechnerscott J and Lugaresi A and Weinstockguttman B and Ozakbas S and Surcinelli A and Foschi M and Boz C and Khoury SJ and Yamout B and Laureys G and Blanco Y and Skibina O and Kuhle J and John N and Alroughani R and Prevost J and Van Pesch V and Tomassini V and Prat A and Girard M and Terzi M and Shaygannejad V and Ampapa R and Gray O and Etemadifar M and Guimaraes J and Mccombe PA and Gerlach O and Solaro C and Butzkueven H and Zhu C and Van Der Walt A and Study Group M}, title = {Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis}, journal = {Journal of Neurology, Neurosurgery and Psychiatry}, volume = {}, number = {}, pages = {-}, year = {2025} }

RIS

TY - JOUR
AU - Foong YC
AU - Merlo D
AU - Gresle M
AU - Buzzard K
AU - Horakova D
AU - Havrdova EK
AU - Kalincik T
AU - Roos I
AU - Hodgkinson S
AU - Lechnerscott J
AU - Lugaresi A
AU - Weinstockguttman B
AU - Ozakbas S
AU - Surcinelli A
AU - Foschi M
AU - Boz C
AU - Khoury SJ
AU - Yamout B
AU - Laureys G
AU - Blanco Y
AU - Skibina O
AU - Kuhle J
AU - John N
AU - Alroughani R
AU - Prevost J
AU - Van Pesch V
AU - Tomassini V
AU - Prat A
AU - Girard M
AU - Terzi M
AU - Shaygannejad V
AU - Ampapa R
AU - Gray O
AU - Etemadifar M
AU - Guimaraes J
AU - Mccombe PA
AU - Gerlach O
AU - Solaro C
AU - Butzkueven H
AU - Zhu C
AU - Van Der Walt A
AU - Study Group M
TI - Moderate-High Efficacy Disease-Modifying Therapies Reduce Relapse Risk in Late-Onset Multiple Sclerosis
JO - Journal of Neurology, Neurosurgery and Psychiatry
VL -
IS -
SP -
EP -
PY - 2025
ER -

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