MS Treatment Infection Risk: Data Gaps Challenge Understanding
- Infections are a notable concern for people living with multiple sclerosis (MS) who receive disease-modifying treatments (DMTs).1 Although clinical trials have documented some infection risks, those studies have...
- A recent systematic review published in Neurological Sciences found that real-world evidence on this safety issue remains limited, with inconsistent findings compared with randomized trial data.
- The Multiple Sclerosis International Federation claims that about 2.9 million people globally live with MS, and the prevalence of the disease has gone up dramatically since 2013 (2.3...
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Infection risk with Multiple Sclerosis Disease-Modifying Therapies
Table of Contents
Introduction
Infections are a notable concern for people living with multiple sclerosis (MS) who receive disease-modifying treatments (DMTs).1 Although clinical trials have documented some infection risks, those studies have often excluded older individuals, people with comorbidities, and those with long disease histories.
A recent systematic review published in Neurological Sciences found that real-world evidence on this safety issue remains limited, with inconsistent findings compared with randomized trial data.
The Multiple Sclerosis International Federation claims that about 2.9 million people globally live with MS, and the prevalence of the disease has gone up dramatically since 2013 (2.3 million), which has often been attributed to improved diagnostic techniques and longer lifespans of people with MS.2
Study Details & Methodology
Researchers from Utrecht University and Amsterdam University Medical Center analyzed observational studies published through April 2023 that compared at least 1 DMT with another or with no therapy, focusing specifically on infection outcomes.1 After screening more than 5300 records from PubMed and Embase, 22 studies met the inclusion criteria. Together, these studies examined 9 therapies, including interferon-β, glatiramer acetate, dimethyl fumarate, fingolimod, natalizumab, ocrelizumab, alemtuzumab, cladribine, and teriflunomide.
The review covered diverse populations. One large Canadian cohort included 6793 people with MS (mean age, 45.4 years; 73.6% women), with 25% exposed to at least 1 DMT. A Swedish registry-based analysis followed 6421 individuals across 8600 treatment episodes, with a mean age of 39 years and 72% women. Follow-up times varied widely, ranging from 1 year to more than a decade.
Key Findings & limitations
Despite the breadth of data, the researchers emphasized how limited the evidence