Disease modifying therapies modulate cardiovascular risk factors in patients with multiple sclerosis

Zohara Sternberg1, Christopher Leung, Daniel Sternberg

  • 1Department of Neurology, Stroke Center, Buffalo Medical Center, Buffalo, NY, USA.

Insights

Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are linked to increased cardiovascular (CV) risk factors. Certain CV drugs may also influence MS disease severity, warranting further investigation.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Multiple sclerosis (MS) management involves disease-modifying therapies (DMTs) with potential systemic effects.
  • Cardiovascular (CV) health is a growing concern in MS patients.
  • Understanding drug interactions is crucial for comprehensive patient care.

Purpose of the Study:

  • To investigate the association between major DMTs (Interferon-beta, Glatiramer acetate, Natalizumab) and CV risk factors in MS.
  • To explore the relationship between CV medications and MS disease severity.
  • To compare CV risk profiles between DMT-users and DMT-naïve MS patients.

Main Methods:

  • Retrospective chart review of 188 DMT-using MS patients and 110 DMT-naïve MS patients.
  • Data collected included anthropometrics, lipid profiles, glucose, blood pressure, smoking status, and medications.
  • MS disease severity was assessed using established scales (EDSS, MSSS).

Main Results:

  • DMT use correlated with higher diastolic blood pressure, plasma glucose, and HDL-C.
  • Interferon-beta and Glatiramer acetate were associated with increased CV risk factors compared to DMT-naïve patients.
  • Natalizumab use was linked to lower CV risk factors.
  • CV and related drug use in DMT-naïve patients associated with higher MS disease severity (EDSS, MSSS).

Conclusions:

  • Higher cardiovascular risk factors are associated with the use of DMTs in MS.
  • CV and related medications may influence MS disease severity, suggesting a potential interplay.
  • Further research is needed to elucidate these complex relationships and optimize treatment strategies.
Abstract

Related Concept Videos

Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
747
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
32
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
762
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
548
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
2.1K
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
621