{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:02:42Z","timestamp":1791442962101,"version":"4.3.3"},"reference-count":162,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008659","name":"European Committee for Treatment and Research in Multiple Sclerosis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical.<\/jats:p>\n                  <jats:p>This topic was discussed during an international focused workshop organized by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in 2023. The aim was to review the current evidence on the rationale for, and the potential pitfalls of, treatment de-escalation in MS. Several clinical scenarios emerged, mainly driven by a change in the benefit-risk ratio of DMTs over the course of the disease and with ageing. The workshop also addressed the issue of de-escalation by the type of DMT used and in specific situations, including pregnancy and paediatric onset MS. Finally, we provide practical guidelines for selecting appropriate patients, defining de-escalation and monitoring modalities and outlining unmet needs in this field.<\/jats:p>","DOI":"10.1093\/brain\/awae409","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T07:48:18Z","timestamp":1734594498000},"page":"1459-1478","source":"Crossref","is-referenced-by-count":35,"title":["De-escalating and discontinuing disease-modifying therapies in multiple sclerosis"],"prefix":"10.1093","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1016-0828","authenticated-orcid":false,"given":"G\u00e9raldine","family":"Androdias","sequence":"first","affiliation":[{"name":"Service de neurologie, scl\u00e9rose en plaques, pathologies de la my\u00e9line et neuro-inflammation, Centre de Ressources, Recherche et Comp\u00e9tence sur la Scl\u00e9rose en Plaques, H\u00f4pital Neurologique Pierre Wertheimer, Hospices Civils de Lyon , 69677 Lyon-Bron ,","place":["France"]},{"name":"Clinique de la Sauvegarde, Ramsay Sant\u00e9 , Lyon 69009 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-708X","authenticated-orcid":false,"given":"Jan D","family":"L\u00fcnemann","sequence":"additional","affiliation":[{"name":"Department of Neurology with Institute of Translational Neurology, University and University Hospital M\u00fcnster , M\u00fcnster 48149 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Maillart","sequence":"additional","affiliation":[{"name":"Department of Neurology, Multiple Sclerosis Center, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, AP-HP , Paris 75013 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pia","family":"Amato","sequence":"additional","affiliation":[{"name":"Departmente NEUROFARBA, University of Florence , Florence 50139 ,","place":["Italy"]},{"name":"IRCCS Fondazione Don Carlo Gnocchi , Florence 50143 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Audoin","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Marseille , Marseille 13005 ,","place":["France"]},{"name":"Centre de R\u00e9sonance Magn\u00e9tique Biologique et M\u00e9dicale (CRMBM), CNRS, Aix Marseille University , Marseille Cedex 5 13385 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7990-5894","authenticated-orcid":false,"given":"Arlette L","family":"Bruijstens","sequence":"additional","affiliation":[{"name":"Department of Neurology, Erasmus Medical Center , Rotterdam 3015 GD ,","place":["The 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