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Updated: Aug 10, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Clinically Manifest Infections Do Not Increase the Relapse Risk in People with Multiple Sclerosis Treated with
Giuseppina Miele1, Simone Cepparulo2, Gianmarco Abbadessa1
1Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80131 Naples, Italy.
Background:
Many factors are believed to be positively associated with the incidence of relapses in people with multiple sclerosis (MS), including infections. However, their role is still controversial. We aimed to investigate whether symptomatic infections in people with MS increase the risk of relapse in the short, medium, or long term.
Materials And Methods:
We enrolled consecutive patients with relapsing MS (RMS) from October to December 2018. From enrolment up to September 2020, an online questionnaire investigating the occurrence of infections was sent via WhatsApp® monthly to the enrolled patients, while in-person visits were performed every six months. When patients complained of symptoms compatible with relapses, they attended an extra in-person visit.
Results:
We enrolled 155 patients with RMS, and 88.38% of patients were treated with disease-modifying therapies. In the dataset, 126,381 total patient days, 78 relapses, and 1202 infections were recorded over a period of about 2 years. No increased risk of relapse after clinically manifest infections was found in the short-, medium-, or long-term period. No correlation was found between all infections and the number of relapses (p = 0.212). The main analyses were repeated considering only those infections that had at least two of the following characteristics: duration of infection ≥ 4 days, body temperature > 37° Celsius, and the use of drugs (antibiotics and/or antivirals), and no significant associations were observed.
Conclusions:
No associations between infections and relapses were observed, likely suggesting that disease-modifying therapies may protect against the risk of relapse potentially triggered by infections.
Insights
Symptomatic infections in people with multiple sclerosis (MS) did not increase relapse risk. Disease-modifying therapies may protect against infection-triggered relapses in MS patients.
Area of Science:
- Neurology
- Immunology
- Epidemiology
Background:
- Infections are suspected triggers for multiple sclerosis (MS) relapses, but evidence remains controversial.
- The precise relationship between symptomatic infections and MS relapse risk requires further investigation.
Purpose of the Study:
- To determine if symptomatic infections elevate the risk of relapse in multiple sclerosis (MS) patients in the short, medium, or long term.
Main Methods:
- 155 patients with relapsing MS (RMS) were monitored for 2 years using monthly online questionnaires and semi-annual in-person visits.
- Data collected included infection occurrence, relapse symptoms, and treatment with disease-modifying therapies (DMTs).
- Analyses assessed correlations between infections and relapses, including stricter infection criteria.
Main Results:
- No increased risk of relapse was observed following symptomatic infections in the short, medium, or long term.
- No significant correlation was found between overall infections and the number of relapses (p = 0.212).
- Even after applying stricter criteria for infection severity, no significant associations with relapses were detected.
Conclusions:
- The study found no evidence linking symptomatic infections to an increased risk of relapse in multiple sclerosis (MS).
- Disease-modifying therapies (DMTs) may play a protective role, potentially mitigating the risk of infection-induced relapses in MS patients.
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