[Expert Solution]: SK is a 56-year-old male diagnosed with…

SK is a 56-year-old male diagnosed with relapsing-remitting MS (RRMS) 10 years ago. He has been stable on ocrelizumab for the past 5 years. However, he has expressed concerns about the increase in fatigue, as it is impacting his quality of life (QOL). What statement best represents the current state of DMT de-escalation or change in therapy in patients like SK? A. Most patients over the age of 55 who are clinically stable opt to discontinue DMTs, therefore we should discontinue ocrelizumab B. To minimize disease progression, the only factor that should be considered when considering de-escalating therapy is evidence of ongoing inflammatory activity C. Switching a patient with clinically stable MS for ≥5 years to a different DMT or changing the dose or dosing frequency should be avoided to minimize risk of relapse D. Best clinical practice in the change/de-escalation of therapy revolves around listening to patients and understanding their short- and long-term goals