Infection incidence and management in multiple sclerosis patients after initiating disease-modifying therapy

Area of Science:

• Neurology
• Pharmacology
• Infectious Disease

Background:

• Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are crucial but expensive and associated with infection risks.
• This study analyzed infection rates and antimicrobial use in 3,204 MS patients over 24 months based on medication route.

Discussion:

• Infection rates were comparable across oral (38.7%), infused (37.3%), and injectable (36.8%) MS medications.
• Antimicrobial prescribing rates for infections were high across all routes: 86.5% (oral), 84.3% (infused), and 85.5% (injectable).
• Specific bacterial and herpes zoster infection rates, along with antimicrobial use, varied among new users depending on the medication's administration route.

Key Insights:

• No significant difference in overall infection rates was observed between oral, infused, and injectable multiple sclerosis therapies.
• Variations in specific infection types (bacterial, herpes zoster) and subsequent antimicrobial use were noted among new medication users based on administration route.
• Pharmacovigilance data can aid shared decision-making when selecting multiple sclerosis treatments.

Outlook:

• Further research into route-specific infection profiles and antimicrobial stewardship is warranted.
• These findings can help clinicians and patients weigh the risks and benefits of different multiple sclerosis medication administration routes.
• Enhanced pharmacovigilance can improve patient safety and optimize treatment selection in multiple sclerosis management.