Abstract Details

Title Falling Through the Cracks: The Distinct Challenges Faced by Young Adults Living With Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 18-010

Objective Understand the demographic characteristics and access to disease modifying therapies (DMTs) in young adults living with multiple sclerosis

Background Multiple Sclerosis (MS) is a distinct condition in young populations, with frequent relapses and earlier progression to irreversible neurological disability compared to adults. Young adults living with MS are at risk for barriers to starting and consistently staying on DMT. However, the characteristics of young adults living with MS, including time to DMT initiation and reasons/rates of DMT non-compliance, have yet to be thoroughly investigated.

Design/Methods Retrospective cohort analysis was conducted on patients aged 18-25 with relapsing-remitting MS (RRMS) or clinically isolated syndrome (CIS) at the University of Utah between 2017 and 2025. Patient-level factors and MS-specific clinical details were collected.

Results Of the 53 patients identified (75.5% female, 62.3% white), 92.5% were diagnosed with RRMS and 7.5% CIS. DMTs were initiated in 92.5%; B-cell depleting agents (42%), dimethyl fumarate (32%) and S1P receptor modulators (12%) were started most frequently. 44.9% of those on DMTs switched to a higher efficacy DMT due to disease progression (47.8%) and side effects (30.4%). Median time to diagnosis from symptom onset was 51 days [IQR: 12-160 days]. Median time to DMT initiation was 51 days [IQR: 27.25 - 94.25 days]. 38.3% of those on DMTs reported medication gaps, with a median of 105 days without DMTs [IQR: 25.5 - 252.75 days]. Most common reasons for gaps in DMT were poor adherence (42.9%) and insurance/cost issues (28.6%). In the last 12 months, 48.7% did not follow up in the planned time frame and 41.0% did not have timely surveillance imaging. Half of the cohort had either relapses or new lesions on imaging since diagnosis. Among these patients, 39.1% occurred during a gap in DMT.

Conclusions Young adults living with MS have high rates of DMT gaps and inadequate timely surveillance and follow-up.

Authors/Disclosures
Yibing Zhang, MD PRESENTER	Dr. Zhang has nothing to disclose.
Ka-Ho Wong (U of U Neurology Clinic)	The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
Jack Wilson	Mr. Wilson has nothing to disclose.
Huapin Huang	Prof. Huang has nothing to disclose.
Tracy E. Schaffer, RN (University of Utah)	Mrs. Schaffer has nothing to disclose.
Regina Farley, RN	Ms. Farley has nothing to disclose.
Tammy L. Smith, MD, PhD (Imaging and Neurosciences Center)	Dr. Smith has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. Smith has received research support from Alexion/AstraZeneca.
Stacey Clardy, MD, PhD, FAAN (University of Utah)	Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory, Penn State, Mayo Clinic, Walter Reed.
John W. Rose, MD, FAAN (Imaging and Neurosciences Center)	The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
Melissa A. Wright, MD (University of Utah)	Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis .

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