Disease Modifying Therapies Withdrawal in Inactive Relapsing-remitting Multiple Sclerosis Patients Aged 55 and Over (TWINS : Therapies Withdrawal IN Relapsing Multiple Sclerosis)

Inclusion criteria

• Patient (male or female) aged 55 and over
• RRMS diagnosis according to revised McDonald 2017 criteria
• First MS symptom >5 years ago. If the date is unknown, RRMS diagnosis >5 years ago
• Stable disease in the last 5 years according to the revised Lublin and Reingold classification characterized by :

Stable T2 lesions documented by MRI performed at least 5 years prior to inclusion versus MRI performed within 6 months prior to the inclusion visit, AND Stable EDSS documented at least 5 years prior to inclusion versus EDSS documented within 6 months prior to inclusion visit, according to the investigator's judgment, AND The absence of relapses within 5 years prior to the inclusion visit

• Treated with a Moderate Efficacy Therapy (MET) for at least 5 consecutive years (IFN-β, glatiramer acetate, dimethyl fumarate, teriflunomide, diroximel fumarate); switching from one first-line treatment to another is accepted if the reason for the change is related to personal convenience or intolerance to the first treatment.
• Patient with affiliation to a social security regimen
• Patient able to understand the objectives and risks associated with the research and to give informed consent to the study
• Patient willing and able to comply with study procedures for the duration of the study

Exclusion criteria

• Primary progressive or secondary progressive with or without relapse as defined by the revised Lublin and Reingold classification
• Previous or ongoing treatment with a High Efficacy therapy (HET), with the exception of induction therapy (mitoxantrone, stem cell transplantation, alemtuzumab) provided that the last administration took place at least 10 years prior to inclusion.
• Contraindication to MRI (claustrophobia, weight ≥ 140 kg, pacemaker, cochlear implants, foreign body in eye, intracranial vascular clips, surgery in the 6 weeks prior to the beginning of the study, coronary stent implanted in the 8 weeks prior to the beginning of the study,…).

NB : Gadolinium contraindication will not prevent recruitment of the patient; in this case MRI will be carried out without contrast product injection

• History of neurological disease affecting the central nervous system: hereditary degenerative CNS disease, degenerative cognitive disease, systemic autoimmune disease, sarcoidosis, Lyme disease…
• Chronic disease which requires chronic treatment with corticoids or immunosuppressors
• Uncontrolled cardiac, renal or hepatic disease
• Patient participating in another interventional trial (drug or a medical device) or patient who are still within an exclusion period
• Patient wishing to discontinue background therapy, whether or not they are experiencing adverse effects.
• Patient not considering discontinuing background therapy, whether or not they are experiencing adverse effects.
• Pregnant or breastfeeding woman
• Patient with difficulty to read or understand French,
• Patient subject to a legal protection measure