Robert T. Naismith, MD, reviewing A registry study associated these therapies with lower relapse rates and MRI activity but not with an impact on disability progression. Patients with late-onset multiple sclerosis (LOMS), defined as disease onset at age 55 or later, face unique therapeutic challenges because LOMS is linked to lower inflammatory activity and more comorbidities than adult-onset MS ( NEJM JW Neurol Mar 26 2024 and Neurology 2024; 102:e208051).