title: Treatment withdrawal in relapsing-remitting multiple sclerosis: a retrospective cohort study.
abstract: BACKGROUND
  To investigate the effect of drug withdrawal on the course of relapsing-remitting multiple sclerosis (RR-MS).
  
  
  METHODS
  An observational cohort retrospective study was performed to compare the time to relapse of patients who discontinued disease-modifying therapy (1a or 1b beta-interferons or glatiramer acetate) with the patients who did not. One hundred and twenty-eight RR-MS patients were investigated using a time-dependent approach.
  
  
  RESULTS
  Over a median follow-up of 108 months, 60 patients discontinued treatment and 89 relapses were observed. The time to relapse was shorter in patients who discontinued treatment compared with those who did not (P < 0.001), median times being 31.1 months (95% confidence interval 10.4-50.8) and 85.8 months (95% confidence interval 58.6-106.3), respectively, whilst the baseline covariates (gender, Expanded Disability Status Scale at diagnosis) did not significantly affect the prognosis.
  
  
  CONCLUSIONS
  It was found that stopping treatment strongly reduces the time to relapse and this information may be useful in patient management.
authors.affiliation: Multiple Sclerosis Center, II Division of Neurology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Lus
authors.affiliation: Multiple Sclerosis Center, II Division of Neurology, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Signoriello
authors.affiliation: Multiple Sclerosis Regional Center, A. Cardarelli, Naples, Italy.
authors.forename: G T
authors.initials: GT
authors.lastname: Maniscalco
authors.affiliation: Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bonavita
authors.affiliation: Medical Statistics Unit, Department of Mental Health and Preventive Medicine, Second University of Napoli, Napoli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Signoriello
authors.affiliation: Medical Statistics Unit, Department of Mental Health and Preventive Medicine, Second University of Napoli, Napoli, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Gallo
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate / Q000008:administration & dosage*; D006801:Humans; D000068556:Interferon beta-1a / Q000008:administration & dosage*; D000068576:Interferon beta-1b / Q000008:administration & dosage*; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D000068556:Interferon beta-1a
keywords: multiple sclerosis; treatment withdrawal