Q&A 77: stopping DMTs due to age

In summary, age and disease duration would not affect my decision not to continue a DMT in a patient like this.

Case study

I have just had my yearly telephone call from my neurologist. Unfortunately, I haven't been able to stop crying since the call. My liver function is abnormal, with the enzymes rising. He has requested an urgent MRI, but if it is the same result as last year's "stable" scan, he would like me to come off the Fingolimod (Gilenya).

My next question was, "What can I then go on to?" and the answer was "nothing".

He said that because I had been diagnosed with MS for nearly twenty-five years and that I am now 52 years of age, it was highly unlikely that I would relapse.

I got so upset when the call ended, as I was so frightened of the possibility of another life-altering relapse.

Apologies for contacting you, but I am very nervous.

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Answers

The core issues, in this case, are the abnormal liver function tests and how to treat someone with MS who has had longstanding MS, who appears stable with no relapses and MRI activity and who is now over the age of 50.