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      The risk of infections for multiple sclerosis and neuromyelitis optica spectrum disorder disease-modifying treatments: Eighth European Committee for Treatment and Research in Multiple Sclerosis Focused Workshop Review. April 2021.

      1 , 2 , 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 10 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 4 , 27 , 28 , 25 , 6 , 10 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 1 , 2
      Multiple sclerosis (Houndmills, Basingstoke, England)
      SAGE Publications
      COVID-19, DMT-associated infections, Multiple sclerosis, SARS-CoV-2, coronavirus disease 2019, disease-modifying treatment, neuromyelitis optica spectrum disorder, progressive multifocal leukoencephalopathy, risk mitigation strategies

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          Abstract

          Over the recent years, the treatment of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) has evolved very rapidly and a large number of disease-modifying treatments (DMTs) are now available. However, most DMTs are associated with adverse events, the most frequent of which being infections. Consideration of all DMT-associated risks facilitates development of risk mitigation strategies. An international focused workshop with expert-led discussions was sponsored by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and was held in April 2021 to review our current knowledge about the risk of infections associated with the use of DMTs for people with MS and NMOSD and corresponding risk mitigation strategies. The workshop addressed DMT-associated infections in specific populations, such as children and pregnant women with MS, or people with MS who have other comorbidities or live in regions with an exceptionally high infection burden. Finally, we reviewed the topic of DMT-associated infectious risks in the context of the current SARS-CoV-2 pandemic. Herein, we summarize available evidence and identify gaps in knowledge which justify further research.

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          Author and article information

          Journal
          Mult Scler
          Multiple sclerosis (Houndmills, Basingstoke, England)
          SAGE Publications
          1477-0970
          1352-4585
          August 2022
          : 28
          : 9
          Affiliations
          [1 ] Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
          [2 ] Sorbonne Université, Inserm, CNRS, UMR7225, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France/ Department of Neurology, Saint Antoine Hospital, AP-HP, Paris, France.
          [3 ] Department of NEUROFARBA, University of Florence, Florence, Italy/IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
          [4 ] Neurology Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
          [5 ] Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
          [6 ] Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
          [7 ] Department of Neurology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
          [8 ] Multiple Sclerosis and Neuroimmunology Program, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland Medical Center, Cleveland, OH, USA.
          [9 ] Sheba Medical Center at Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
          [10 ] Department of NEUROFARBA, University of Florence, Florence, Italy.
          [11 ] Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia/Institute of Clinical Neurology and Department of Neuroimmunology, Federal Center of Brain Research and Neurotechnologies, Moscow, Russia.
          [12 ] St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
          [13 ] Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
          [14 ] Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK/Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK.
          [15 ] Center for Research on Neuroimmunological Diseases, FLENI, Buenos Aires, Argentina.
          [16 ] Neurology Unit, Neurorehabilitation Unit and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milan, Italy.
          [17 ] Department of Neurology and Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
          [18 ] Department of Neurology, Razi Hospital, Tunis, Tunisia.
          [19 ] Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, London, UK.
          [20 ] Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany.
          [21 ] Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
          [22 ] Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital, University of Basel, Basel, Switzerland.
          [23 ] Neurology Department, Hospital Santo António dos Capuchos, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
          [24 ] CRCSEP Côte d'Azur, CHU de Nice Pasteur 2, UR2CA-URRIS, Université Nice Côte d'Azur, Nice, France.
          [25 ] Sorbonne Université, Inserm, CNRS, UMR7225, Institut du Cerveau et de la Moelle épinière (ICM), Paris, France/Sorbonne University, Paris Brain Institute-ICM, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, Paris, France.
          [26 ] Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Copenhagen, Denmark.
          [27 ] Department of Neurology, Hospital Clínico San Carlos, Idissc, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
          [28 ] Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, India.
          [29 ] Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
          [30 ] Collegium Medicum, Department of Neurology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland/Center of Neurology, Lodz, Poland.
          [31 ] Clinical Outcomes Research Unit, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.
          [32 ] Department of Neurology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey.
          [33 ] Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
          [34 ] Department of Health Sciences, University of Genoa and IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
          [35 ] Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro," Bari, Italy.
          [36 ] Hadassah-Hebrew University Medical Center, Department of Neurology, The Agnes-Ginges Center for Neurogenetics Jerusalem, Jerusalem, Israel.
          [37 ] Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France/Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France/Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, Lyon, France.
          [38 ] Department of Neurology, Mayo Clinic, Rochester, MN, USA.
          [39 ] Department of Neurology with Institute of Translational Neurology, University of Muenster, Münster, Germany.
          [40 ] Department of Neurology, University of Rostock, Rostock, Germany.
          [41 ] MS Clinic, Instituto Neurológico de Colombia and Medicarte, Medellin, Colombia.
          Article
          10.1177/13524585211069068
          35196927
          2c1795a8-9e68-4d75-b18a-a7eeceb3ef6d
          History

          COVID-19,DMT-associated infections,Multiple sclerosis,SARS-CoV-2,coronavirus disease 2019,disease-modifying treatment,neuromyelitis optica spectrum disorder,progressive multifocal leukoencephalopathy,risk mitigation strategies

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