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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Infectious risk stratification in multiple sclerosis patients receiving immunotherapy.
Jonas Graf1, Verena I Leussink1, Thomas Dehmel2
1Department of Neurology University Hospital Medical Faculty Heinrich-Heine-University Düsseldorf Germany.
Annals of Clinical and Translational Neurology
|January 4, 2018
Summary
Latent tuberculosis infection is common in German multiple sclerosis patients. Screening before immunotherapy is crucial to prevent tuberculosis reactivation during treatment for multiple sclerosis or NMOSD.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Potent treatments for multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) necessitate infection screening.
- Latent infections pose a risk of reactivation during immunosuppressive therapy.
Purpose of the Study:
- To determine the prevalence of infections, specifically latent tuberculosis infection (LTBI), in German patients with MS/NMOSD.
- To assess the need for pre-treatment screening for LTBI in this patient population.
Main Methods:
- Retrospective chart review of MS/NMOSD patients who underwent infection testing between 2014 and 2016.
- Analysis of two independent German patient cohorts (Düsseldorf and Münster).
Main Results:
- Latent tuberculosis infection was identified in 3.95% of tested patients (95% CI: 2-8%).
- Specifically, 6 out of 80 patients in the Düsseldorf cohort and 2 out of 97 in the Münster cohort had LTBI.
- The prevalence of LTBI exceeded 1% in both cohorts.
Conclusions:
- Latent tuberculosis infection is a frequent comorbidity in German patients with MS/NMOSD.
- Routine screening for LTBI is recommended before initiating immunomodulatory therapies.
- Early detection and treatment of LTBI can mitigate the risk of reactivation during MS/NMOSD treatment.
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