When can we consider de-escalation or even discontinuation of a high-efficient immunotherapy for MS without risking a disease worsening?

You can read the full article on my blog: https://ms-perspektive.com/83-deescalation

Hello and welcome to another summary of ECTRIMS 2024, this time on the topic of de-escalation and discontinuation of therapy. There was a scientific session on this topic with six lectures, moderated by Dr. Melinda Magyari and Prof. Bernhard Hemmer. And there were also individual posters. Except for one talk about NMOSD and MOGAD, all scientific contributions were about multiple sclerosis.

I will present all the contributions and their results, some of which are still preliminary. After all, it is a topic that probably affects most of us. Can or should I switch my therapy from a high efficacy to a lower one or even stop it altogether at some point, and when is that a safe approach?

Table of Contents

• What does de-escalation of therapy mean?
• Why is de-escalation a topic?
• Strategies for de-escalation with anti CD20 therapies
• Discontinuation and de-escalation in NMOSD and MOGAD
• Guiding Treatment Deescalation in Relapsing Remitting Multiple Sclerosis
• Alternate-Day Fingolimod Tapering: Impact on Rebound Disease Activity in Patients with Multiple Sclerosis
• Short-term B cell depletion results in medication-free, long-term freedom from disease activity and correction of immune tolerance defect in a subset of people with relapsing MS
• B-cell tailored dosing versus standard interval dosing of ocrelizumab in relapsing-onset MS –Interim analysis of a randomized controlled trial (BLOOMS trial)
• De-escalation treatment strategies in patients with relapsing-remitting multiple sclerosis in Austria
• Classification of the risk of disease reactivation after de-escalation/discontinuation of disease-modifying therapy in relapsing-remitting MS using the VIAADISC score

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See you soon and try to make the best out of your life, Nele

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