How does your decision to use high-efficacy disease-modifying treatments (HET) differ, if at all, when treating late-onset relapsing-remitting multiple sclerosis?  

For late-onset patients who still have evidence of active disease (gad-enhancing lesions on MRI within the past 1-2 years), I will treat with HET, such as anti-CD20 therapy. Older individuals tend to have less ability to fully recover post-relapses than younger persons. I would be more hesitant to u...

There is good evidence that patients with late-onset MS (LOMS) have a greater risk for progression/disability. However, since many patients with LOMS have prior disease burden evident on MRI, it remains unclear if the increased progression risk relates to unique phenotypic pathology or rather missed...