MS breakthrough? trial tests if older patients can ditch heavy drugs

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion criteria : * Patients ≥40 years at inclusion * Patients with relapsing remitting multiple sclerosis at inclusion (according to 2017 McDonald criteria) treated with anti-CD20 for at least the last 3 years. For patients treated with IV ocrelizumab or rituximab at extended interval dosing, a maximum interval of 12 months between perfusions during the year before inclusion visit is required. * No evidence of disease activity for the last 3 years on anti-CD20 (No relapse AND no new/enlarged MRI lesion) * Brain MRI performed according to OFSEP protocol within a maximum of 6 months before randomization Non-inclusion criteria : * Secondary or primary progressive MS at inclusion * Previous experience of treatment failure in patients treated with natalizumab, fingolimod, rituximab, ocrelizumab, mitoxantrone, alemtuzumab or cladribine * Treatment with high dose corticosteroids during the 30 days preceding inclusion * Contraindication to MRI * Severely immunocompromised state * Current severe active infection * Known active malignancy * Severe heart failure (New York Heart Association Class IV) or severe, uncontrolled cardiac disease * Severe hepatic impairment (Child-Pugh class C) * Significantly impaired bone marrow function or significant anaemia, leukopenia, neutropenia or thrombocytopenia * Severe renal impairment undergoing dialysis * Severe hypoproteinaemia, e.g. in nephrotic syndrome * Current severe depression and/or suicidal ideation * Suspected or confirmed progressive multifocal leukoencephalopathy (PML) * Any condition that, in the opinion of the investigator, would interfere with the interpretation of patient safety or place the patient at high risk for treatment-related complications * Participation in another therapeutic trial in the last 6 months * Protected population according to articles of the French Public Health Code (e.g. patients under law protection, prisoners, pregnant, parturient or lactating women, and patients under guardianship/curatorship) * All women of childbearing age not using effective contraception during the study * Subjects not covered by public health insurance * Failure to obtain written informed consent after a reflection period