Infection Risks Among Patients With Multiple Sclerosis Treated With Fingolimod, Natalizumab, Rituximab, and Injectable Therapies

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Abstract

Although highly effective disease-modifying therapies for multiple sclerosis (MS) have been associated with an increased risk of infections vs injectable therapies interferon beta and glatiramer acetate (GA), the magnitude of potential risk increase is not well established in real-world populations. Even less is known about infection risk associated with rituximab, which is extensively used off-label to treat MS in Sweden.

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Most cited references 7

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Disease-modifying therapies and infectious risks in multiple sclerosis.

Alexander Winkelmann, Uwe Zettl, Hans-Peter Hartung … (2016)

Immunomodulatory and immunosuppressive treatments for multiple sclerosis (MS) are associated with an increased risk of infection, which makes treatment of this condition challenging in daily clinical practice. Use of the expanding range of available drugs to treat MS requires extensive knowledge of treatment-associated infections, risk-minimizing strategies and approaches to monitoring and treatment of such adverse events. An interdisciplinary approach to evaluate the infectious events associated with available MS treatments has become increasingly relevant. In addition, individual stratification of treatment-related infectious risks is necessary when choosing therapies for patients with MS, as well as during and after therapy. Determination of the individual risk of infection following serial administration of different immunotherapies is also crucial. Here, we review the modes of action of the available MS drugs, and relate this information to the current knowledge of drug-specific infectious risks and risk-minimizing strategies.

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Disease-modifying drugs for multiple sclerosis and infection risk: a cohort study.

José Maria Andreas Wijnands, Feng Zhu, Elaine Kingwell … (2018)

Little is known about disease-modifying treatments (DMTs) for multiple sclerosis (MS) and infection risk in clinical practice. We examined the association between DMTs and infection-related medical encounters.

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Infections in Patients Receiving Multiple Sclerosis Disease-Modifying Therapies

Elena Grebenciucova, Amy A Pruitt (2017)

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Author and article information

Journal

Title: JAMA Neurology

Abbreviated Title: JAMA Neurol

Publisher: American Medical Association (AMA)

ISSN (Print): 2168-6149

Publication date (Electronic): October 07 2019

Affiliations

[1 ]Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

[2 ]Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

[3 ]Department of Neuroscience, Uppsala University, Uppsala, Sweden

[4 ]Center for Health and Medical Psychology, Örebro University, Örebro, Sweden

[5 ]Clinical and Translational Neuroscience, Southern California Permanente Medical Group, Kaiser Permanente, Pasadena

[6 ]Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden

[7 ]Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden

[8 ]Department of Pharmacology and Clinical Neuroscience, Umea University, Umea, Sweden

[9 ]Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden

[10 ]Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden

[11 ]Department of Neurology, Karolinska University Hospital, Stockholm, Sweden

[12 ]Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden

Article

DOI: 10.1001/jamaneurol.2019.3365

PMC ID: 6784753

PubMed ID: 31589278

SO-VID: 3f38c9df-fb48-44b5-be75-4a040b0bf6c4

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