1 Willumsen JS et al. Mortality and cause of death in multiple sclerosis in western Norway 1950–2021: a registry-based linkage study. J. Neurol. Neurosurg. Psychiatry 2022;93: 1154–1161.
2 Lunde HMB, Assmus J, Myhr KM et al. Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study. J. Neurol. Neurosurg. Psychiatry 2017;88:621–625.
3 Simpson S et al. Trends in the epidemiology of multiple sclerosis in Greater Hobart, Tasmania: 1951 to 2009. J. Neurol. Neurosurg. Psychiatry 2011;82:180–187.
4 Naseri A, Nasiri E, Sahraian MA et al. Clinical Features of Late-Onset Multiple Sclerosis: a Systematic Review and Meta-analysis. Mult. Scler. Relat. Disord. 2021;50:102816.
5 Tena-Cucala, R. et al. The 2024 McDonald criteria show comparable sensitivity to previous criteria for late-onset multiple sclerosis. Mult. Scler. Relat. Disord. 2025;103:106658.
6 Barkhof F et al. 2024 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI for the diagnosis of multiple sclerosis. Lancet Neurol. 2025;24:866–879.
7 Vaughn CB et al. Epidemiology and treatment of multiple sclerosis in elderly populations. Nat. Rev. Neurol. 2019;15:329–342.
8 Palathinkara M, Razzak AN, Ababneh OE et al. Clinical and radiologic differences between early onset, late onset, and very late onset adult multiple sclerosis. Mult. Scler. Relat. Disord. 2023;80:105132.
9 Coerver EM et al. Aging is associated with reduced inflammatory disease activity independent of disease duration in relapsing multiple sclerosis trial populations. Mult. Scler. J. 2024;30:1296–1308.
10 Salter A, Lancia S, Kowalec K et al. Comorbidity and Disease Activity in Multiple Sclerosis. JAMA Neurol.2024;81:1170.
11 Marrie RA et al. Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis. Neurology 2010;74:1041–1047.
12 Mrochen A, Meuth S G, Pfeuffer S. Should we stay or should we go? Recent insights on drug discontinuation in multiple sclerosis. Neurol. Res. Pract. 2025;7:25.
13 Palladino R, Marrie RA, Majeed A et al. Management of vascular risk in people with multiple sclerosis at the time of diagnosis in England: A population-based study. Mult. Scler. J. 2023;29:671–679.
14 Nezamzadeh F, Masroor A, Esmailkhani A et al. Exploring the complex interplay: insulin resistance and gut microbiome dysbiosis in multiple sclerosis. Neuroscience 2025;582:134–145.
15 Chataway J et al. Effect of repurposed simvastatin on disability progression in secondary progressive multiple sclerosis (MS-STAT2): a phase 3, randomised, double-blind, placebo-controlled trial. The Lancet 2025;406:1611–1624.
16 Khambhati, J. et al. Immunotherapy for the prevention of atherosclerotic cardiovascular disease: Promise and possibilities. Atherosclerosis 2018;276:1–9.
17 Dal Bianco, A. et al. Multiple sclerosis and Alzheimer’s disease. Ann. Neurol. 2008;63:174–183.
18 Luczynski P, Laule C, Hsiung GYR et al. Coexistence of Multiple Sclerosis and Alzheimer’s disease: A review. Mult. Scler. Relat. Disord. 2019;27:232–238.
19 Fernández Ó et al. Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review. Front. Immunol. 2024;15:1379538.
20 Al-Araji S et al. Effectiveness of Disease-Modifying Therapies in Patients With Late-Onset Relapsing-Remitting Multiple Sclerosis. Neurology 2025;105:e213967.
21 Pfeuffer S et al. Association of Clinical Relapses With Disease Outcomes in Multiple Sclerosis Patients Older Than 50 Years. Neurology 2024;103:e209574.
22 Pawlitzki M, Meuth SG. MS-Therapie im Alter - Was gilt es zu bedenken? DNP - Neurol. Psychiater 2020;21:36–41.
23 Shirani A et al. Multiple Sclerosis in Older Adults: The Clinical Profile and Impact of Interferon Beta Treatment. BioMed Res. Int. 2015:1–11.
24 Mouresan EF et al. Clinical Characteristics and Long-Term Outcomes of Late-Onset Multiple Sclerosis: A Swedish Nationwide Study. Neurology 2024;102:e208051.
25 Devonshire V et al. Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study. Lancet Neurol. 2012;11:420–428.
26 Wolinsky JS et al. Glatiramer acetate in primary progressive multiple sclerosis: Results of a multinational, multicenter, double‐blind, placebo‐controlled trial. Ann. Neurol. 2007;61: 14–24.
27 Lublin F et al. Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial. The Lancet 2016;387:1075–1084.
28 Hawker K et al. Rituximab in patients with primary progressive multiple sclerosis: Results of a randomized double‐blind placebo‐controlled multicenter trial. Ann. Neurol. 2009;66:460–471.
29 Montalban X et al. Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis. N Engl J Med 2017;376:209–220.
30 Weideman AM, Tapia-Maltos MA, Johnson K et al. Meta-analysis of the Age-Dependent Efficacy of Multiple Sclerosis Treatments. Front. Neurol. 2017;8:577.
31 Prosperini L et al. Age as a risk factor for early onset of natalizumab-related progressive multifocal leukoencephalopathy. J. Neurovirol. 2017;23:742–749.
32 Pierret C et al. Cancer Risk Among Patients With Multiple Sclerosis: A 10-Year Nationwide Retrospective Cohort Study. Neurology 2024;103:e209885.
33 Gieselbach RJ et al. Progressive multifocal leukoencephalopathy in patients treated with fumaric acid esters: a review of 19 cases. J. Neurol. 2017;264:1155–1164.
34 Mills EA, Mao-Draayer Y. Aging and lymphocyte changes by immunomodulatory therapies impact PML risk in multiple sclerosis patients. Mult Scler 2018;24:1014–1022.
35 Sriwastava S et al. Progressive multifocal leukoencephalopathy and sphingosine 1-phosphate receptor modulators used in multiple sclerosis: an updated review of literature. J. Neurol. 2022;269:1678–1687.
36 Mears V et al. Predictors of hypogammaglobulinemia and serious infections among patients receiving ocrelizumab or rituximab for treatment of MS and NMOSD. J. Neuroimmunol. 2023;377:578066.
37 Monschein T et al. Safety of disease-modifying therapies in multiple sclerosis: real-world data from the Austrian MS Treatment Registry (AMSTR). J. Neurol. 2025;272:774.
38 Alping P et al. Cancer Risk for Fingolimod, Natalizumab, and Rituximab in Multiple Sclerosis Patients. Ann Neurol 2020;87:688–699.
39 Askari M et al. Incidence of cancer in patients with multiple sclerosis (MS) who were treated with fingolimod: A systematic review and meta-analysis. Mult. Scler. Relat. Disord. 2022;59:103680.
40 Rice JB, White AG, Scarpati LM et al. Long-term Systemic Corticosteroid Exposure: A Systematic Literature Review. Clin. Ther. 2017;39:2216–2229.
41 Marsili L et al. Neurological immune-related adverse events of immune checkpoint inhibitors: clinical and hematological risk factors. J. Neurol. 2026;273:5.
42 Pawlitzki M, Baermann BN, Dietrich S, Meuth SG. Multiple Sklerose und Onkologie: Neue Perspektiven an der Schnittstelle zweier Disziplinen. Dtsch Arztebl 2025;122(16):6; doi: 10.3238/PersNeuro.2025.08.08.012025.
43 Quinn CM et al. Neurologic Outcomes in People With Multiple Sclerosis Treated With Immune Checkpoint Inhibitors for Oncologic Indications. Neurology 2024;103:e210003.
44 Pawlitzki M et al. Umstellung von Fingolimod - wie gelingt der sichere Wechsel? NeuroTransmitter 2025;36:42–47.
45 Bsteh G et al. Discontinuation of disease-modifying therapies in multiple sclerosis - Clinical outcome and prognostic factors. Mult Scler 2017;23:1241–1248.
46 Lo Re M et al. Natalizumab Discontinuation and Treatment Strategies in Patients with Multiple Sclerosis (MS): A Retrospective Study from Two Italian MS Centers. Neurol. Ther. 2015;4:147–157.
47 Konen FF et al. Switching from anti-CD20 therapies to cladribine and vice versa – Analysis of a German relapsing multiple sclerosis cohort. Neurotherapeutics 2025;e00812. doi:10.1016/j.neurot.2025.e00812.
48 Jouvenot G et al. High-Efficacy Therapy Discontinuation vs Continuation in Patients 50 Years and Older With Nonactive MS. JAMA Neurol. 2024;81:490.
49 Corboy JR et al. Risk of new disease activity in patients with multiple sclerosis who continue or discontinue disease-modifying therapies (DISCOMS): a multicentre, randomised, single-blind, phase 4, non-inferiority trial. Lancet Neurol. 2023;22:568–577.
50 Coerver EME et al. Discontinuation of First-Line Disease-Modifying Therapy in Patients With Stable Multiple Sclerosis: The DOT-MS Randomized Clinical Trial. JAMA Neurol. 2025;82:123.
51 Pawlitzki M et al. Gekommen, um zu bleiben - die Rolle von Serum-NfL als Biomarker. NeuroTransmitter 2025;36:52–61.
52 Abdelhak A et al. Serum neurofilament light chain reference database for individual application in paediatric care: a retrospective modelling and validation study. Lancet Neurol 2023;22(9):826-833. doi: 10.1016/S1474-4422(23)00210-7.
53 Bittner S, Oh J, Havrdova EK et al. The potential of serum neurofilament as biomarker for multiple sclerosis. Brain 2021;144:2954–2963.
54 Abdelhak A et al. Neurofilament Light Chain Elevation and Disability Progression in Multiple Sclerosis. JAMA Neurol. 2023;80:1317.
55 Abdelhak A et al. Blood GFAP as an emerging biomarker in brain and spinal cord disorders. Nat Rev Neurol 2022;18:158–172.
56 Ammitzbøll C et al. NfL and GFAP in serum are associated with microstructural brain damage in progressive multiple sclerosis. Mult. Scler. Relat. Disord. 2023;77:104854.
57 Yaldizli Ö et al. Personalized treatment decision algorithms for the clinical application of serum neurofilament light chain in multiple sclerosis: A modified Delphi Study. Mult. Scler. J. 2025;31:932–943.