Late-onset MS treatments show comparable real-world outcomes

A real-world study involving 447 adults has found that two common disease-modifying therapies for late-onset multiple sclerosis (LOMS) provide similar clinical benefits. The research, utilizing data from the international MSBase registry, compared anti-CD20 treatments with sphingosine-1-phosphate (S1P) receptor modulators in patients whose symptoms began after age 50.

The study reported no statistically significant differences between the two groups regarding relapse rates or confirmed disability progression. Annual relapse rates were low for both, averaging 0.03 per year for anti-CD20 therapies and 0.05 per year for S1P receptor modulators. Approximately 15 to 20 percent of patients in both groups experienced confirmed disability worsening, with a median time to progression of roughly 18 months.

Late-onset MS, which accounts for about one in ten new diagnoses, often follows a more progressive course with faster disability accumulation than earlier-onset versions. While the primary outcomes were similar, exploratory machine learning suggested anti-CD20 therapies might offer additional benefits for specific subgroups, such as those diagnosed within two years of symptom onset.