{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:44:15Z","timestamp":1787161455753,"version":"build-2736575974"},"reference-count":24,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Foundation of the Consortium of Multiple Sclerosis Centers"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2025,8]]},"DOI":"10.1016\/j.msard.2025.106552","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T12:04:40Z","timestamp":1748347480000},"page":"106552","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"special_numbering":"C","title":["De-escalation of disease modifying therapies: A retrospective, observational single center study"],"prefix":"10.1016","volume":"100","author":[{"given":"Carolyn","family":"Goldschmidt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Glassman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Ly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devon S.","family":"Conway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengke","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tucker","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-3978","authenticated-orcid":false,"given":"Le H.","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.msard.2025.106552_bib0022","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1002\/ana.24651","article-title":"Rituximab versus fingolimod after natalizumab in multiple sclerosis patients","volume":"79","author":"Alping","year":"2016","journal-title":"Ann. Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0017","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2025.106257","article-title":"Comparing the efficacy and safety of extended vs standard dosing of ocrelizumab in MS: a systemic review and meta-analysis","volume":"94","author":"Baig","year":"2025","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2025.106552_bib0023","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1001\/jamaneurol.2013.6240","article-title":"Switching from Natalizumab to Fingolimod in multiple sclerosis: a French prospective study","volume":"71","author":"Cohen","year":"2014","journal-title":"JAMA Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0009","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/S1474-4422(23)00154-0","article-title":"Risk of new disease activity in patients with multiple sclerosis who continue or discontinue disease-modifying therapies (DISCOMS): A multicentre, randomised, single-blind, phase 4, non-inferiority trial","volume":"22","author":"Corboy","year":"2023","journal-title":"Lancet Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0019","unstructured":"R. Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing, https:\/\/www.R-project.org\/(2023)."},{"key":"10.1016\/j.msard.2025.106552_bib0015","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1177\/1352458520952036","article-title":"De-escalating rituximab dose results in stability of clinical, radiological, and serum neurofilament levels in multiple sclerosis","volume":"27","author":"Disanto","year":"2021","journal-title":"Mult. Scler."},{"key":"10.1016\/j.msard.2025.106552_bib0021","doi-asserted-by":"crossref","DOI":"10.1111\/ene.70042","article-title":"De-escalation of disease-modifying therapy in multiple sclerosis\u2014A Danish nationwide cohort study","volume":"32","author":"Elberling","year":"2025","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0001","article-title":"Early and unrestricted access to high-efficacy disease-modifying therapies: a consensus to optimize benefits for people living with multiple sclerosis","author":"Filippi","year":"2021","journal-title":"J. Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0011","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/1471-2377-13-101","article-title":"Interferon beta 1b following natalizumab discontinuation: one year, randomized, prospective, pilot trial","volume":"13","author":"Gobbi","year":"2013","journal-title":"BMC Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0003","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/jamaneurol.2018.4905","article-title":"Clinical outcomes of escalation vs early intensive disease-modifying therapy in patients with multiple sclerosis","volume":"76","author":"Harding","year":"2019","journal-title":"JAMA Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0012","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/s00415-011-5996-y","article-title":"De-escalation from natalizumab in multiple sclerosis: recurrence of disease activity despite switching to glatiramer acetate","volume":"258","author":"Havla","year":"2011","journal-title":"J. Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0007","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1177\/1352458518765656","article-title":"Discontinuation of disease-modifying therapy in patients with multiple sclerosis over age 60","volume":"25","author":"Hua","year":"2019","journal-title":"Mult. Sclerosis J."},{"key":"10.1016\/j.msard.2025.106552_bib0020","doi-asserted-by":"crossref","DOI":"10.1001\/jamaneurol.2024.0395","article-title":"High-efficacy therapy discontinuation vs continuation in patients 50 years and older with nonactive MS","author":"Jouvenot","year":"2024","journal-title":"JAMA Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0024","doi-asserted-by":"crossref","DOI":"10.1007\/s40263-025-01164-w","article-title":"Treatment de-escalation in relapsing-remitting multiple sclerosis: an observational study","author":"M\u00fcller","year":"2025","journal-title":"CNS Drugs"},{"key":"10.1016\/j.msard.2025.106552_bib0016","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1177\/13524585241250199","article-title":"Memory B cell\u2013guided extended interval dosing of ocrelizumab in multiple sclerosis","volume":"30","author":"Meng","year":"2024","journal-title":"Mult. Scler."},{"key":"10.1016\/j.msard.2025.106552_bib0006","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1474-4422(19)30151-6","article-title":"Early highly effective versus escalation treatment approaches in relapsing multiple sclerosis","volume":"18","author":"Ontaneda","year":"2019","journal-title":"Lancet Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0004","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1007\/s13311-020-00847-0","article-title":"Induction versus escalation in multiple sclerosis: a 10-year real world study","volume":"17","author":"Prosperini","year":"2020","journal-title":"Neurotherapecutics"},{"key":"10.1016\/j.msard.2025.106552_bib0008","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s40263-023-01038-z","article-title":"Stopping disease-modifying treatments in Multiple sclerosis: a systematic review and meta-analysis of real-world studies","volume":"37","author":"Prosperini","year":"2023","journal-title":"CNS Drugs"},{"key":"10.1016\/j.msard.2025.106552_bib0018","doi-asserted-by":"crossref","DOI":"10.1111\/ene.14162","article-title":"Multiple Sclerosis Performance Test: validation of self-administered neuroperformance modules","author":"Rao","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0013","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1756285611428503","article-title":"Treatment de-escalation after mitoxantrone therapy: results of a phase IV, multicentre, open-label, randomized study of subcutaneous interferon beta-1a in patients with relapsing multiple sclerosis","volume":"5","author":"Rieckmann","year":"2012","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"10.1016\/j.msard.2025.106552_bib0014","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2024.106145","article-title":"De-escalation from anti-CD20 to cladribine tablets in multiple sclerosis: a pilot study","volume":"92","author":"Sacco","year":"2024","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2025.106552_bib0005","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1001\/jamaneurol.2021.2738","article-title":"Treatment escalation vs immediate initiation of highly effective Treatment for patients with relapsing-remitting multiple sclerosis: data from 2 different national strategies","volume":"78","author":"Spelman","year":"2021","journal-title":"JAMA Neurol."},{"key":"10.1016\/j.msard.2025.106552_bib0002","doi-asserted-by":"crossref","first-page":"e636","DOI":"10.1212\/NXI.0000000000000636","article-title":"An argument for broad use of high efficacy treatments in early multiple sclerosis","volume":"7","author":"Stankiewicz","year":"2019","journal-title":"Neurol. Neuroimmunol. Neuroinflamm."},{"key":"10.1016\/j.msard.2025.106552_bib0010","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.799138","article-title":"Evolution of disease modifying therapy benefits and risks: an argument for de-escalation as a treatment paradigm for patients with multiple sclerosis","volume":"12","author":"Vollmer","year":"2022","journal-title":"Front. Neurol."}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034825002949?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034825002949?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T23:12:28Z","timestamp":1754003548000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034825002949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":24,"alternative-id":["S2211034825002949"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2025.106552","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"De-escalation of disease modifying therapies: A retrospective, observational single center study","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2025.106552","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"106552"}}