Related Experiment Video
Updated: May 21, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Infections in patients with multiple sclerosis treated with disease-modifying therapies: A comparative risk
Mohammad Reza Fattahi1,2, Amir Valizadeh3, Amirreza Azimi1
1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:
Background: The major treatment regimens for multiple sclerosis (MS) are disease-modifying therapies (DMTs). Fungal, viral, and bacterial infections are common complications of these drugs. Also, MS itself is an immune-related chronic disease that can compromise their subjects to infections. Therefore, MS can be a risk factor for infectious complications. Methods: This paper is a retrospective cohort study conducted from February 2020 to January 2022 using prospectively collected data from every patient registered at the Multiple Sclerosis Referral Research Center in Tehran, Iran. We inducted patients with MS who were diagnosed based on McDonald's criteria and exposed to DMTs for at least 6 months prior to this study. Being under 18 years of age, diagnosis change during the study, and mortality were the exclusion criteria of this study. Results: We inducted a total of 979 patients into this study. Finally, data from 798 participants were analyzed. Rituximab and natalizumab were associated with a higher risk of urinary tract infection (UTI) and bacterial vaginitis. Moreover, rituximab, glatiramer acetate, and dimethyl fumarate were associated with HSV-associated ulceration. None of the investigated DMTs were associated with an altered risk of COVID-19. Conclusion: The use of DMTs can result in an increased risk of infections in patients. The selection of these DMTs should be based on their efficacy and risk of complications. Healthcare providers should familiarize themselves with these complications to select the appropriate DMTs with the highest efficacy.
Insights
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) increase infection risk. Rituximab and natalizumab are linked to urinary tract infections and bacterial vaginitis, while other DMTs are associated with HSV ulcerations.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Multiple sclerosis (MS) is a chronic immune-related disease increasing infection susceptibility.
- Disease-modifying therapies (DMTs) are standard MS treatments but can lead to complications like infections.
- MS patients face a heightened risk of infectious complications due to their condition and treatments.
Purpose of the Study:
- To investigate the association between specific DMTs and infectious complications in MS patients.
- To identify which DMTs are linked to increased risks of specific infections.
- To inform clinical decisions regarding DMT selection based on infection risk profiles.
Main Methods:
- Retrospective cohort study using prospectively collected data from February 2020 to January 2022.
- Inclusion of MS patients diagnosed by McDonald's criteria and on DMTs for at least six months.
- Exclusion of patients under 18, those with diagnosis changes, or mortality during the study.
Main Results:
- Analysis of data from 798 MS patients revealed specific DMT-infection associations.
- Rituximab and natalizumab were linked to higher risks of urinary tract infections (UTIs) and bacterial vaginitis.
- Rituximab, glatiramer acetate, and dimethyl fumarate were associated with herpes simplex virus (HSV)-associated ulcerations; no DMTs altered COVID-19 risk.
Conclusions:
- DMT use in MS patients is associated with an increased risk of various infections.
- Careful consideration of DMT efficacy versus complication risks is crucial for patient management.
- Healthcare providers must be aware of potential infectious complications to optimize DMT selection for MS patients.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:11Bioavailability Study Design: Single Versus Multiple Dose Studies