New initiative to support MS treatment decisions in older adults
Project will bring together patients, clinicians to review DISCO-MS data
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A woman takes part in a video conference. (Photo from iStock)
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The Accelerated Cure Project received funding to support treatment decisions for older adults with multiple sclerosis.
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The DISCO-MS study found stopping treatment increased MRI activity in stable older patients, while relapse rates were similar.
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ACP will develop resources for patients and clinicians to help interpret research and support treatment decisions.
The Accelerated Cure Project for Multiple Sclerosis (ACP) has received funding to help interpret and share findings from the DISCO-MS study, which examined whether older adults with stable multiple sclerosis (MS) could stop disease-modifying medications, to support more informed treatment decisions.
The award comes through the Eugene Washington PCORI Engagement Award Program, an initiative of the Patient-Centered Outcomes Research Institute (PCORI).
Project will bring together stakeholders to review evidence
With this support, the ACP will bring together patients, caregivers, clinicians, researchers, and advocates to review available evidence and create plain-language resources for both patients and clinicians.
“DISCO-MS is a landmark study, and it deserves to be understood in its full context,” Stephanie Buxhoeveden, PhD, chief scientific officer at the ACP, said in a press release from the nonprofit organization. “For older adults navigating these decisions with their doctors, getting the interpretation right isn’t an academic exercise. It has real consequences for how they live with this disease.”
This initiative aims to make research more useful in practice and bring patient perspectives into the discussion — something that has largely been missing from research on aging and MS treatment decisions. Instead of focusing on a single study, the ACP will consider results of DISCO-MS (NCT03073603), along with other research and real-world data, to provide a clearer picture of treatment decisions for older adults with MS.
MS is a long-term neurodegenerative disease that affects the brain and spinal cord and can cause symptoms that may worsen over time. Disease-modifying treatments can slow disease progression and reduce relapses — periods when symptoms suddenly worsen or new ones appear — but they can also have side effects, particularly in older adults.
Aging MS population raises questions about treatment decisions
Today, the average age of people living with MS is over 55. Because relapses and MRI disease activity tend to decline as people age, questions have emerged about whether older people with long-standing stable disease may safely reduce or stop treatment.
But these decisions are not simple, in part because older adults have been underrepresented in clinical trials, and it’s not entirely clear how stopping treatment may affect them.
Sponsored by the University of Colorado Denver, DISCO-MS tested whether patients ages 55 and older with stable MS — defined as no relapses for at least five years and no new MRI activity for at least three years — could stop their disease-modifying treatments compared with continuing them.
The study found that people who stopped treatment experienced more disease activity, particularly new MRI brain lesions, than those who continued therapy. The findings suggest that some older adults may still benefit from continuing these treatments, even if their disease appears stable.
Still, relapse rates were not significantly different between groups, and those who discontinued treatment reported higher satisfaction, according to the researchers.
DISCO-MS results highlight complexity of stopping treatment
Because these results are not straightforward, this initiative will help interpret and explain them clearly, providing the context needed to support treatment decision-making.
As part of the initiative, patients, caregivers, doctors, researchers, and advocates will meet for two virtual discussions to review the evidence and develop plain-language resources to support better-informed conversations.
The group will also produce a consensus statement summarizing current evidence to support clinical decision-making, as well as a research agenda outlining key gaps in understanding MS and aging.
