b"Medicine & Research Doctors NotesThe MS News column includes analysis from BenThrower, M.D., MS Focus senior medical advisor. He drawsfrom the top news stories of the quarter and explainswhat the news means to you, the person with MS.Christine Willis, MLIS, AHIP, is the Clinical InformationLibrarian at Children's Healthcare of Atlanta, EglestonHospital.Study considers when The not so simple question is, when? MS isDMT usage might enddriven by a relatively overactive, dysregulatedResearchers in Europe and the United States immunesystemthatisinappropriatelycontributed a special commentary in the journal attacking myelin and axons in the CNS. TheCurrent Opinions in Neurology discussing human immune system tends to calm downthe reasons and evidence to consider when or mellow as we age. This is called immunediscontinuing disease-modifying therapies senescence. Immune senescence can be bothon a temporary or permanent basis. The a good and bad thing. An immune systemauthors reviewed studies reported in the past that has weakened too much with age couldtwo years. Their findings showed that for lead to a higher risk of infections, such asindividuals who have shown no evidence of pneumonia. Immune senescence in a persondisease activity, after discussion with their with MS could mean there is little risk forneurologist, could consider discontinuation to clinical relapses or new lesions on MRI. Theresave them from side-eects of the medications, is, however, great variability from person toinconvenience, and costs. Older patients person as to when immune senescence occurs.may stop DMTs because of complications or From a practical standpoint, we must considercomorbidities. Some patients for whom MS how stable a persons MS has been in recentcontinues to progress may also permanently years,medicationside-effects,financialbe abandoned. The researchers mention a challenges, and individual risk tolerance incurrent clinical trial that includes 260 participants making an informed decision about stoppingin a prospective interventional study to an MS disease-modifying therapy. Hopefully,compare disease activity of those who stop future research will give us more tools to aidDMTs and those who do not. The authors do in making this important decision.note that after withdrawal of DMTs continued Lifestyle modications keymonitoringforbreakthroughdiseaseis to living with MSmandatory. A study on cardiovascular risk in individualsDr. ThrowerOne of the hardest questions withMS wasconductedbyresearchersatthatcomesupinMSClinicsaroundthe Ceara State University, in Fortaleza, Brazil, andworld daily is, Can I stop my MS therapy at used the Framingham risk score to calculatesome point? The simple answer is, probably. the study participants risk. The MS group59 msfocusmagazine.org"