Background: The disease-modifying therapies (DMTs) largely used in multiple sclerosis (MS) may result in higher infectious risk. Objective: We aimed to investigate the infectious risk in DMT-treated MS patients. Methods: MS patients were evaluated for infectious risk before starting, switching or during DMT. Results: In this three-year observational cohort study 174 MS patients were enrolled. Among them, 18 patients were anti-HBc + and 19 patients were QuantiFERON®-TB Gold In-Tube (QFT)  +  . No patients with anti-HBc + showed a detectable HBV-DNA and all started DMT. Among QTB + patients, 17 latent TB infections (LTBIs) and 2 active TB infections (TBIs) were identified. After one month of LTBI prophylaxis or TB treatment, respectively, all patients started DMTs.Overall, 149 started DMTs. During DMTs, one ocrelizumab-treated patient with anti-HBc + developed HBV reactivation and six patients (3 on natalizumab, 2 on ocrelizumab and 1 on IFN-β) showed reactivation of HSV-1, with detectable plasma DNA. Finally, 1 cladribine-treated patient experienced VZV reactivation. All the reactivations of latent infections have been successfully treated. Conclusion: Screening of infectious diseases in DMT candidate MS patients helps to mitigate the infectious risk. During DMTs, a regular assessment of infectious risk allows to avoid discontinuing MS therapy and guarantees a higher degree of safety.

Zingaropoli, M., Pasculli, P., Iannetta, M., Perri, V., Tartaglia, M., Crisafulli, S., et al. (2022). Infectious risk in multiple sclerosis patients treated with disease-modifying therapies: a three-year observational cohort study. MULTIPLE SCLEROSIS JOURNAL, EXPERIMENTAL, TRANSLATIONAL AND CLINICAL, 8(1) [10.1177/20552173211065731].

Infectious risk in multiple sclerosis patients treated with disease-modifying therapies: a three-year observational cohort study

Iannetta M;
2022-01-01

Abstract

Background: The disease-modifying therapies (DMTs) largely used in multiple sclerosis (MS) may result in higher infectious risk. Objective: We aimed to investigate the infectious risk in DMT-treated MS patients. Methods: MS patients were evaluated for infectious risk before starting, switching or during DMT. Results: In this three-year observational cohort study 174 MS patients were enrolled. Among them, 18 patients were anti-HBc + and 19 patients were QuantiFERON®-TB Gold In-Tube (QFT)  +  . No patients with anti-HBc + showed a detectable HBV-DNA and all started DMT. Among QTB + patients, 17 latent TB infections (LTBIs) and 2 active TB infections (TBIs) were identified. After one month of LTBI prophylaxis or TB treatment, respectively, all patients started DMTs.Overall, 149 started DMTs. During DMTs, one ocrelizumab-treated patient with anti-HBc + developed HBV reactivation and six patients (3 on natalizumab, 2 on ocrelizumab and 1 on IFN-β) showed reactivation of HSV-1, with detectable plasma DNA. Finally, 1 cladribine-treated patient experienced VZV reactivation. All the reactivations of latent infections have been successfully treated. Conclusion: Screening of infectious diseases in DMT candidate MS patients helps to mitigate the infectious risk. During DMTs, a regular assessment of infectious risk allows to avoid discontinuing MS therapy and guarantees a higher degree of safety.
gen-2022
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/17 - MALATTIE INFETTIVE
English
Multiple sclerosis
disease-modifying therapies
infectious risk
Zingaropoli, M., Pasculli, P., Iannetta, M., Perri, V., Tartaglia, M., Crisafulli, S., et al. (2022). Infectious risk in multiple sclerosis patients treated with disease-modifying therapies: a three-year observational cohort study. MULTIPLE SCLEROSIS JOURNAL, EXPERIMENTAL, TRANSLATIONAL AND CLINICAL, 8(1) [10.1177/20552173211065731].
Zingaropoli, M; Pasculli, P; Iannetta, M; Perri, V; Tartaglia, M; Crisafulli, S; Merluzzo, C; Baione, V; Mazzochi, L; Taglietti, A; Pauri, F; Frontoni...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/287853
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