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Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach
BACKGROUND: Multiple sclerosis treatment has changed in the last years with the emergence of new disease-modifying therapies (DMTs). Despite a better efficacy profile, these drugs raise concerns about infectious risk, which needs to be mitigated. OBJECTIVE: To analyze the results of a systematic col...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436289/ https://www.ncbi.nlm.nih.gov/pubmed/34526834 http://dx.doi.org/10.1177/11795735211042188 |
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author | Ferro, Daniela Prista-Leão, Beatriz Costa, Andreia Silva-Pinto, André Abreu, Cândida Sá, Maria José |
author_facet | Ferro, Daniela Prista-Leão, Beatriz Costa, Andreia Silva-Pinto, André Abreu, Cândida Sá, Maria José |
author_sort | Ferro, Daniela |
collection | PubMed |
description | BACKGROUND: Multiple sclerosis treatment has changed in the last years with the emergence of new disease-modifying therapies (DMTs). Despite a better efficacy profile, these drugs raise concerns about infectious risk, which needs to be mitigated. OBJECTIVE: To analyze the results of a systematic collaborative approach between Neurology and Infectious Diseases (ID) Departments in the management of infectious risk and complications in MS patients treated with DMT. METHODS: Retrospective collection of MS patients’ demographic and clinical data from clinical records of MS and ID outpatient clinics (2011–2017). RESULTS: We included 149 patients: most had evidence of previous contact with Herpesviridae, and half of them were not immune to hepatitis A and B viruses (HAV and HBV). Vaccines for HAV, HBV, and Streptococcus pneumoniae were administered in 91%, 78%, and 88% of non-immune patients, respectively. JC virus serology monitoring prevented natalizumab (NTZ) initiation or prompted its switch in 34/122 patients. Forty patients had latent tuberculosis, in which 88% were treated. Infectious events occurred in 33 patients, mostly mild urinary, respiratory, and herpes virus group infections. Only three patients required inpatient care. CONCLUSION: Facing the expansion of the new DMT, we highlight the benefits of an interdisciplinary approach for safer use of the chosen treatment. |
format | Online Article Text |
id | pubmed-8436289 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84362892021-09-14 Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach Ferro, Daniela Prista-Leão, Beatriz Costa, Andreia Silva-Pinto, André Abreu, Cândida Sá, Maria José J Cent Nerv Syst Dis Original Research Article BACKGROUND: Multiple sclerosis treatment has changed in the last years with the emergence of new disease-modifying therapies (DMTs). Despite a better efficacy profile, these drugs raise concerns about infectious risk, which needs to be mitigated. OBJECTIVE: To analyze the results of a systematic collaborative approach between Neurology and Infectious Diseases (ID) Departments in the management of infectious risk and complications in MS patients treated with DMT. METHODS: Retrospective collection of MS patients’ demographic and clinical data from clinical records of MS and ID outpatient clinics (2011–2017). RESULTS: We included 149 patients: most had evidence of previous contact with Herpesviridae, and half of them were not immune to hepatitis A and B viruses (HAV and HBV). Vaccines for HAV, HBV, and Streptococcus pneumoniae were administered in 91%, 78%, and 88% of non-immune patients, respectively. JC virus serology monitoring prevented natalizumab (NTZ) initiation or prompted its switch in 34/122 patients. Forty patients had latent tuberculosis, in which 88% were treated. Infectious events occurred in 33 patients, mostly mild urinary, respiratory, and herpes virus group infections. Only three patients required inpatient care. CONCLUSION: Facing the expansion of the new DMT, we highlight the benefits of an interdisciplinary approach for safer use of the chosen treatment. SAGE Publications 2021-09-08 /pmc/articles/PMC8436289/ /pubmed/34526834 http://dx.doi.org/10.1177/11795735211042188 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Ferro, Daniela Prista-Leão, Beatriz Costa, Andreia Silva-Pinto, André Abreu, Cândida Sá, Maria José Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title | Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title_full | Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title_fullStr | Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title_full_unstemmed | Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title_short | Infectious Risk Mitigation in Patients with Multiple Sclerosis under Disease-Modifying Therapies – the Experience of a Collaborative Neurology-Infectious Diseases Approach |
title_sort | infectious risk mitigation in patients with multiple sclerosis under disease-modifying therapies – the experience of a collaborative neurology-infectious diseases approach |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436289/ https://www.ncbi.nlm.nih.gov/pubmed/34526834 http://dx.doi.org/10.1177/11795735211042188 |
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