Discontinuation of disease-modifying therapy in stable multiple sclerosis: A systematic review and meta-analysis

BACKGROUND Disease-modifying therapies (DMTs) are used to manage multiple sclerosis (MS), particularly in individuals with relapse-onset MS, to slow disease progression, reduce inflammation and demyelination and improve quality of life. Discontinuing treatment may pose a greater relapse risk for younger individuals with active disease, whereas the safety of treatment cessation in older, stable patients remains uncertain. METHODS We conducted a systematic review and meta-analysis of studies comparing discontinuation of disease-modifying therapy in stable multiple sclerosis patients. Data were collected from PubMed, Embase, and Cochrane Central databases. Statistical analysis was performed using Review Manager v5.4. A random-effects model was applied to pool risk ratios (RRs) and 95 % confidence intervals, with statistical significance set at p < 0.05. RESULTS A total…