title: Medication withdrawal may be an option for a select group of patients in relapsing-remitting multiple sclerosis.
abstract: This article describes the clinical and radiological evolution of a stable group of patients with relapsing-remitting multiple sclerosis that had their disease-modifying therapy (DMT) withdrawn. Forty patients, which had made continuous use of one immunomodulator and had remained free of disease for at least 5 years, had their DMT withdrawn and were observed from 13 to 86 months. Out of the followed patients, 4 (10%) patients presented with new attacks. In addition to these patients, 2 (5%) patients had new lesions revealed by magnetic resonance imaging that did not correspond to clinical attacks. Despite these results, the difficult decision to withdraw medication requires careful analysis. Withdrawal, however, should not be viewed as simply the suspension of treatment because these patients should be evaluated periodically, and the immunomodulators should be readily reintroduced if new attacks occur. Nonetheless, medication withdrawal is an option for a select group of patients.
authors: Irmandade da Santa Casa de Misericórdia de São Paulo, SP, Brasil. guilhermesolival@gmail.com
authors: Guilherme Sciascia do
authors: GS
authors: Olival
authors: Vitor Breseghello
authors: VB
authors: Cavenaghi
authors: Vitor
authors: V
authors: Serafim
authors: Rodrigo Barbosa
authors: RB
authors: Thomaz
authors: Charles Peter
authors: CP
authors: Tilbery
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000473:pathology; D010455:Peptides / Q000008:administration & dosage; D011446:Prospective Studies; D016079:Refusal to Treat
chemical_list: D000276:Adjuvants, Immunologic; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a