R Persson1, S Lee2, M Ulcickas Yood3, Capt M Wagner Usn Mc4, N Minton2, S Niemcryk2, A Lindholm2, A M Evans5, S S Jick6. 1. Boston Collaborative Drug Surveillance Program, Lexington, MA, USA. 2. Bristol-Myers Squibb, Summit, NJ, USA. 3. EpiSource, LLC, Newton, MA, USA; Boston University School of Public Health, Boston, MA, USA. 4. Department of Neurology, Naval Medical Center Portsmouth, Portsmouth, VA, USA. 5. Health ResearchTx, LLC, Trevose, PA, USA. 6. Boston Collaborative Drug Surveillance Program, Lexington, MA, USA; Boston University School of Public Health, Boston, MA, USA. Electronic address: sjick@bu.edu.
Abstract
BACKGROUND: Recent data on the rates of infections among patients with multiple sclerosis (MS) are sparse. The objective of this study was to quantify incidence of infections in patients with MS compared with a matched sample of patients without MS (non-MS). METHODS: This study was conducted in two separate electronic medical databases: the United States Department of Defense (US-DOD) military health care system and the United Kingdom's Clinical Practice Research Datalink GOLD (UK-CPRD). We identified patients with a first recorded diagnosis of MS between 2001 and 2016 (UK-CPRD) or 2004 and 2017 (US-DOD) and matched non-MS patients. We identified infections recorded after the MS diagnosis date (or the matched date in non-MS patients) and calculated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) by infection site and type. RESULTS: Relative to non-MS patients, MS patients had higher rates of any infection (US-DOD IRR 1.76; 95% CI 1.72-1.80 and UK-CPRD IRR 1.25; 95% CI 1.21-1.29) and a two-fold higher rate of hospitalized infections (US-DOD IRR 2.43; 95% CI 2.23-2.63 and UK-CPRD IRR 2.00; 95% CI 1.84-2.17). IRs of any infection were higher in females compared with males in both MS and non-MS patients, while IRs of hospitalized infections were similar between sexes in both MS and non-MS patients. The IR of first urinary tract or kidney infection was nearly two-fold higher in MS compared with non-MS patients (US-DOD IRR 1.88; 95% CI 1.81-1.95 and UK-CPRD IRR 1.97; 95% CI 1.86-2.09) with higher rates in females compared with males. IRs for any opportunistic infection, candidiasis and any herpes virus were increased between 20 and 52% among MS patients compared with non-MS patients. IRs of meningitis, tuberculosis, hepatitis B and C were all low. CONCLUSION: MS patients have an increased risk of infection, notably infections of the renal tract, and a two-fold increased risk of hospitalized infections compared with non-MS patients.
BACKGROUND: Recent data on the rates of infections among patients with multiple sclerosis (MS) are sparse. The objective of this study was to quantify incidence of infections in patients with MS compared with a matched sample of patients without MS (non-MS). METHODS: This study was conducted in two separate electronic medical databases: the United States Department of Defense (US-DOD) military health care system and the United Kingdom's Clinical Practice Research Datalink GOLD (UK-CPRD). We identified patients with a first recorded diagnosis of MS between 2001 and 2016 (UK-CPRD) or 2004 and 2017 (US-DOD) and matched non-MSpatients. We identified infections recorded after the MS diagnosis date (or the matched date in non-MSpatients) and calculated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) by infection site and type. RESULTS: Relative to non-MSpatients, MSpatients had higher rates of any infection (US-DOD IRR 1.76; 95% CI 1.72-1.80 and UK-CPRD IRR 1.25; 95% CI 1.21-1.29) and a two-fold higher rate of hospitalized infections (US-DOD IRR 2.43; 95% CI 2.23-2.63 and UK-CPRD IRR 2.00; 95% CI 1.84-2.17). IRs of any infection were higher in females compared with males in both MS and non-MSpatients, while IRs of hospitalized infections were similar between sexes in both MS and non-MSpatients. The IR of first urinary tract or kidney infection was nearly two-fold higher in MS compared with non-MSpatients (US-DOD IRR 1.88; 95% CI 1.81-1.95 and UK-CPRD IRR 1.97; 95% CI 1.86-2.09) with higher rates in females compared with males. IRs for any opportunistic infection, candidiasis and any herpes virus were increased between 20 and 52% among MSpatients compared with non-MSpatients. IRs of meningitis, tuberculosis, hepatitis B and C were all low. CONCLUSION:MSpatients have an increased risk of infection, notably infections of the renal tract, and a two-fold increased risk of hospitalized infections compared with non-MSpatients.
Authors: Stephanie Trend; Jonatan Leffler; Ingrid Teige; Björn Frendéus; Allan G Kermode; Martyn A French; Prue H Hart Journal: Front Immunol Date: 2021-01-11 Impact factor: 7.561
Authors: Nabil Seery; Sifat Sharmin; Vivien Li; Ai-Lan Nguyen; Claire Meaton; Roberts Atvars; Nicola Taylor; Kelsey Tunnell; John Carey; Mark P Marriott; Katherine A Buzzard; Izanne Roos; Chris Dwyer; Josephine Baker; Lisa Taylor; Kymble Spriggs; Trevor J Kilpatrick; Tomas Kalincik; Mastura Monif Journal: CNS Drugs Date: 2021-04-13 Impact factor: 5.749