Infections in patients with multiple sclerosis: Implications for disease-modifying therapy

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Multiple sclerosis (MS) patients exhibit a higher susceptibility to infections than the general population.
• This increased infection risk is linked to both disease-related disability and the use of disease-modifying therapies.
• The advent of potent immunomodulatory drugs introduces further complexities, potentially elevating risks for bacterial, viral, fungal, or parasitic infections based on their specific mechanisms of action.

Purpose of the Study:

• To highlight the multifaceted risks of infection in multiple sclerosis (MS) patients.
• To emphasize the importance of considering drug mechanisms and patient comorbidities in treatment decisions.
• To advocate for enhanced monitoring and data collection through treatment registries.

Main Methods:

• Review of existing literature on infection risks in multiple sclerosis.
• Analysis of the impact of disease-modifying drugs (DMDs) on infection susceptibility.
• Discussion of treatment considerations based on drug mechanisms, infection types, and patient comorbidities.

Main Results:

• Infection risk in MS is multifactorial, influenced by disability and therapeutic interventions.
• Potent immunomodulatory drugs can induce specific types of infections (bacterial, viral, fungal, parasitic) depending on their mode of action.
• Individualized treatment strategies are necessary, balancing efficacy with infection risk.

Conclusions:

• Treatment decisions for MS patients with infections require careful consideration of the specific drug's mechanism of action and associated infection risks.
• Comorbidities play a significant role in managing infections in this patient population.
• Implementation of treatment registries is essential for improved understanding and management of infections in MS.