Escalation versus induction therapy for relapsing MS starting after age 50
Escalation vs. Induction Therapy Strategy in Patients With Early-Onset MS After Age 50
This project will test whether starting with stronger, highly effective treatments or beginning with moderate drugs and escalating later changes the risk of inflammatory relapses for people whose relapsing MS began after age 50.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 830 (estimated) |
| Ages | 50 Years and up |
| Sex | All |
| Sponsor | University Hospital, Strasbourg, France Academic / other |
| Drugs / interventions | natalizumab, rituximab, ocrelizumab, ofatumumab |
| Locations | 1 site (Strasbourg) |
| Trial ID | NCT07313462 on ClinicalTrials.gov |
What this trial studies
This retrospective observational study compares two treatment strategies—starting with moderately effective disease-modifying drugs then escalating versus starting with highly effective induction therapies—in patients whose relapsing-remitting MS began after age 50. Investigators will include patients who began their first disease-modifying therapy within two years of symptom onset and who received specified moderate or high-efficacy DMARDs. Medical records from the Centre d'Investigation Clinique at CHU de Strasbourg will be used to compare inflammatory disease activity, relapse rates, and treatment-related complications between groups. The analysis will also search for patient and treatment factors associated with inflammatory relapse or complications.
Who should consider this trial
Good fit: Ideal candidates are people with relapsing-remitting MS whose first symptoms began after age 50, who started a first DMT within two years of onset, and who received one of the listed moderate or high-efficacy DMARDs.
Not a fit: Patients with early progressive MS, those who began treatment more than two years after symptom onset, or people without accessible treatment records at the recruiting center may not benefit from the study findings.
Why it matters
Potential benefit: If successful, the results could help doctors choose the initial treatment strategy that lowers relapse risk and limits complications for people with MS beginning after age 50.
How similar studies have performed: Similar comparisons of escalation versus induction strategies have been done in younger MS populations with mixed results, but this question is relatively under-studied for onset after age 50.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients with RRMS onset after age 50 * Patients who started their first disease-modifying therapy within 2 years of the first symptoms * Patients Treated with moderately effective disease-modifying antirheumatic drugs (DMARDs) (teriflunomide, dimethyl fumarate or diroximel fumarate, glatiramer acetate, interferon beta, peginterferon) * Patient treated with highly effective DMARDs (fingolimod, ponesimod, natalizumab, rituximab, ocrelizumab, ofatumumab, cladribine) Exclusion Criteria: \- Patients with early progressive MS
Where this trial is running
Strasbourg
- Centre d'Investigation Clinique - CHU de Strasbourg - France — Strasbourg, France (Recruiting)
Study contacts
- Study coordinator: Nicolas Collongues, MD
- Email: nicolas.collongues@chru-strasbourg.fr
- Phone: 33 3.88.12.87.33
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.