Observational studyJournal of neurology2026
The impact of age on efficacy and safety of disease modifying treatment-insights from the Austrian Multiple Sclerosis Treatment Registry.
Observational study in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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9 authors.
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Abstract
introductionEfficacy and safety considerations in the treatment of multiple sclerosis (MS) change over a person's lifetime due to immunosenescence and the increasing prevalence of comorbidities with advancing age. OBJECTIVES/
aimsTo evaluate the overall efficacy and safety of disease-modifying therapies in MS patients across different age groups using prospectively collected real-world data from a nationwide observational cohort.
methodsWe included patients from the Austrian MS Treatment Registry (AMSTR) who were receiving treatment with Alemtuzumab, Cladribine, Dimethyl fumarate, Fingolimod, Natalizumab, Ocrelizumab, Ofatumumab, Ozanimod, Ponesimod, Siponimod, and Teriflunomide for at least 12 months as of March 2025. Patients were categorized into two age groups: < 50 years (n = 1,459) and ≥ 50 years (n = 658). A generalized linear model (GLM) and Cox proportional hazards models were applied to assess treatment effects on annualized relapse rates (ARR) and changes in the Expanded Disability Status Scale (EDSS), including both progression and improvement.
resultsOver a mean treatment duration of 6.0 years (younger cohort) and 7.8 years (older cohort), the estimated mean ARR was 0.12 and 0.09, respectively (p < 0.001). Cox regression analysis of time to first relapse yielded a hazard ratio (HR) of 1.34 (95% CI 1.12-1.60, p = 0.001), indicating a significantly higher relapse risk for the younger cohort. For sustained EDSS progression at 12 and 24 weeks, the corresponding HRs were 0.76 (95% CI 0.64-0.912, p = 0.003) and 0.70 (95% CI 0.58-0.85, p < 0.001), respectively, demonstrating a higher risk of disability progression in the older cohort.
conclusionOur findings indicate that approximately one-third of treated MS patients in our registry are aged 50 years or older, underscoring the substantial presence of older patients in contemporary MS treatment cohorts. Furthermore, efficacy outcomes, including ARR and EDSS progression, differed significantly between younger and older age groups. These results suggest that both disease activity and chronological age are primary determinants of treatment outcomes.
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