ArticleEuropean journal of neurology2025
De-Escalation of Disease-Modifying Therapy in Multiple Sclerosis-A Danish Nationwide Cohort Study.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- The Art of Sequencing Disease-Modifying Therapies in Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2026Review
- Managing Relapsing Multiple Sclerosis Across the Lifespan: A Narrative Review with Expert Opinion from Norway.Neurology and therapy · 2026Review
- Building Towards Initiation, Moderation, De-Escalation and Cessation of Disease-Modifying Treatments for Multiple Sclerosis in Greece: An Expert Panel Consensus Meeting.Brain sciences · 2026Article
- Comparative Effectiveness and Risk of Severe Infection in Adult Patients With MS Treated With Diroximel Fumarate Versus Anti-CD20 Monoclonal Antibodies: A Real-World Claims Analysis.Advances in therapy · 2026Article
- Modulation of the immunological and neuroinflammatory microenvironment in older people with multiple sclerosis.Frontiers in immunology · 2026Review
- The Glymphatic-Venous Axis in Brain Clearance Failure: Aquaporin-4 Dysfunction, Biomarker Imaging, and Precision Therapeutic Frontiers.International journal of molecular sciences · 2025Review
- Predictors of therapy switching to high-efficacy disease-modifying therapies in patients with multiple sclerosis: a single center, retrospective, observational study.Frontiers in neurology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveHigh-efficacy (HE) disease-modifying therapies (DMT) are increasingly used to treat multiple sclerosis (MS). Concerns arise when considering the decreasing efficacy and increasing risk of adverse events in aging patients. We aimed to describe disease activity and treatment trajectories in patients with MS who de-escalated from an HE DMT to an moderate-efficacy (ME) DMT.
methodsWe performed a cohort study based on data from the Danish Multiple Sclerosis Registry (DMSR) including patients with relapsing-remitting MS (RRMS), who switched from an HE DMT to an ME DMT as defined by Danish authorities. We included patients from October 2007 to July 2023. Median follow-up time was 0.8 years (IQR 0.3-2.5).
resultsIn total 333 patients (76.0% females, mean age: 45.1 years) de-escalated for various reasons. Most patients de-escalated from natalizumab or fingolimod (43.8% and 42.0%, respectively) to dimethyl fumarate (47.5%). At 2 years after de-escalation, the cumulative risk of relapse was 38% (95% CI 31-44) and 53% (95% CI 46-60) for inflammatory disease activity (relapses and/or radiological disease activity). Age (HR 0.96, 95% CI 0.94-0.98) and inflammatory disease activity prior to de-escalation (HR 2.05, 95% CI 1.45-2.91) were associated with inflammatory disease activity post de-escalation. DISCUSSION: De-escalation from primarily natalizumab and fingolimod did not effectively ensure disease stability in this cohort. Younger age and inflammatory disease activity prior to de-escalation were risk factors for inflammatory disease activity post de-escalation, which can help guide future studies on de-escalation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.