Discontinuing Disease-Modifying Therapies in Nonactive Secondary Progressive MS: Review of the Evidence

Abstract

Background: There are currently no disease-modifying therapies (DMTs) on the market approved for nonactive secondary progressive multiple sclerosis (SPMS), and lifelong DMTs are neither indicated nor supported by evidence. Nevertheless, the discontinuation of DMTs has been a long-debated topic with varied opinions on how and when to discontinue. Observations: This article reviews the current literature regarding the discontinuation of DMTs in nonactive SPMS. Discontinuing DMTs does not seem to have deleterious effects on the nonactive SPMS disease course and may improve quality of life. Conclusions: The growing evidence in this area may make discontinuation of DMTs in nonactive SPMS a less debatable topic, but it is still a major treatment decision that clinicians must thoroughly discuss with the patient to provide high-quality, patient-centered care.