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Therapeutic Drug Monitoring: Affecting Factors01:29

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Microsporidia are a group of obligate intracellular fungi that were initially classified as protists but were later reclassified based on phylogenetic, molecular, and structural evidence linking them to the Chytridiomycota. These unicellular, non-motile organisms are highly specialized parasites that infect a wide range of animal hosts, including humans. They have evolved extensive genomic and metabolic reductions, making them highly dependent on their hosts for survival.Morphology and Genomic...
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Infections in patients with multiple sclerosis: Implications for disease-modifying therapy.

E G Celius1,2

  • 1Department of Neurology, Oslo University Hospital, Oslo, Norway.

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Patients with multiple sclerosis (MS) face higher infection risks due to disability and potent treatments. Understanding drug mechanisms and infection risks is crucial for managing MS patients effectively.

Keywords:
disease-modifying therapyinfectionsmultiple sclerosisprogressive multifocal leukoencephalopathy

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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.