Disease Modifying Therapies – Risk Management Poster Presentation

P0375 - Quantifying the risk of disease reactivation after DMT discontinuation – the VIAADISC score (ID 765)

  • G. Bsteh
  • G. Bsteh
  • H. Hegen
  • K. Riedl
  • P. Altmann
  • M. Auer
  • K. Berek
  • F. Di Pauli
  • R. Ehling
  • B. Kornek
  • T. Monschein
  • W. Rinner
  • C. Schmied
  • S. Wurth
  • A. Zinganell
  • G. Zulehner
  • T. Zrzavy
  • F. Deisenhammer
  • P. Rommer
  • F. Leutmezer
  • T. Berger
Presentation Number
Presentation Topic
Disease Modifying Therapies – Risk Management



There is a lack of evidence guiding treatment decisions regarding discontinuation of disease-modifying therapy (DMT) in multiple sclerosis (MS)


To generate and validate a composite (clinical and MRI-based) score able to identify individual patients with relapsing MS (RMS) with a high risk of experiencing disease reactivation after discontinuation of DMT.


The study was conducted using a generation and a validation dataset drawn from two separate prospectively collected observational databases. We included RMS patients who received interferon-beta or glatirameracetate for ≥12 months, then discontinued DMT for ≥6 months and had ≥2 years of follow-up available. In the generation sample (n=168), regression analysis was performed to identify clinical or MRI variables independently predicting disease reactivation after DMT discontinuation. A predictive score was calculated using the variables included in the multivariable model. This score was then applied to the validation sample (n=98).


The variables included in the final model as independent predictors of disease reactivation were age at discontinuation (p<0.001), MRI activity at discontinuation (p<0.001), and duration of clinical stability (p<0.001). The resulting score (Vienna Innsbruck DMT discontinuation score based on age, activity on MRI and duration in stable course; VIAADISC) was able to identify patients at high (83-84%), moderate (35-38%) and low risk (7%) of disease reactivation within 5 years after DMT discontinuation both in the generation and in the validation cohorts.


The composite VIAADISC score may be a valuable tool informing patients and neurologists in the face of deciding if and when to discontinue injectable DMTs.