New research presented at CMSC 2025 questions the long-term benefits of disease-modifying therapies (DMTs) in multiple sclerosis (MS), suggesting that these therapies may not improve mobility outcomes and could be associated with higher health care utilization.

MS is a chronic immune-mediated condition characterized by neurodegeneration and central nervous system inflammation. While DMTs are widely used to reduce relapses and MRI disease activity, their effect on disability progression has been less clear. A recent analysis by the New York State MS Consortium raised eyebrows when it found that untreated patients with MS experienced less disease progression—an observation the authors attributed to potential baseline differences in disease severity.

Seeking to further explore this trend, researchers conducted a single-center, retrospective cohort study that matched 39 DMT-naive patients with 39 patients who had received DMTs. Matching criteria included sex, race, age, years since diagnosis, and comparable radiological disease severity at diagnosis. The primary outcome assessed was mobility status at the most recent visit (unable to walk vs walking with or without assistance), and secondary outcomes included total emergency room (ER) visits and hospitalizations since diagnosis.

The findings were striking. There was no statistically significant difference in walking status between treated and untreated patients (P = 0.6), although untreated patients showed a slight numerical advantage. However, patients who received DMTs had significantly more ER visits (IRR: 1.68; 95% CI, 1.39–2.03; P < 0.001) and hospitalizations (IRR: 1.71; 95% CI, 1.32–2.23; P < 0.001).

These results suggest that DMTs may not provide long-term benefits in preserving mobility and are associated with increased health care resource use. According to the investigators, these findings underscore the importance of carefully weighing the risks and benefits of DMT exposure, particularly in patients with potentially milder disease presentations.

Reference

Ahmed, Hernandez RS, Obeidat AZ. Impact of treatment on mobility and healthcare utilization in multiple sclerosis patients: a retrospective matched cohort analysis. Presented at: CMSC 2025; May 28-May30, 2025; Phoenix, AZ; Abstract QOL05.