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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.
Objectives:
This retrospective study aimed to determine (1) the association between the use of three major disease modifying therapies (DMTs) (Interferon-beta [IFN-β], Glatiramer acetate [GA], Natalizumab [NTZ]) and cardiovascular (CV) risk factors in multiple sclerosis (MS) patients, and (2) the association between the use of CV drugs (antihypertensive, hypolipidemic, and antiplatelets) and other drugs acting on the CV system (antispastics/anticonvulsants/anxyolitics, antidepressants/stimulants), and MS disease severity.
Methods:
The charts of 188 patients with MS, who were taking one of the three DMTs, and 110 patients, who were naïve to these drugs, were retrospectively reviewed. The obtained data included height and weight, fasting lipid profiles, plasma glucose, systolic and diastolic BP, smoking habit, list of medications, and indicators of MS disease severity.
Results:
The use of DMTs was associated with higher diastolic BP readings, as well as higher plasma glucose and HDL-C plasma levels. In addition, there was an association between CV risk factors and the type of DMTs. When compared to DMT-naïve patients with MS, the use of IFN-β and GA was associated with higher CV risk factors, whereas the use of NTZ was associated with lower CV risk factors. In DMT-naïve patients, the use of CV and related drugs was associated with higher Extended Disability Status Scale (EDSS) and higher MS Severity Scale (MSSS).
Conclusion:
There is an association between higher CV risk factors and the use of DMTs. Furthermore, CV and related drugs have the potential for modulating MS disease severity.
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