Anna Castelo-Branco1, Flaminia Chiesa1, Simona Conte1, Camilla Bengtsson2, Sally Lee3, Neil Minton3, Steve Niemcryk3, Anders Lindholm3, Mats Rosenlund4, Fredrik Piehl5, Scott Montgomery6. 1. Real-world Insights, IQVIA Nordics, Pyramidvägen 7, 169 56 Solna, Sweden. 2. Real-world Insights, IQVIA Nordics, Pyramidvägen 7, 169 56 Solna, Sweden. Electronic address: cbengtsson@iqvia.com. 3. Celgene Corporation, 86 Morris Avenue, Summit, NJ 07901, United States. 4. Department of Learning, Informatics, Management and Ethics (LIME), Tomtebodavägen 18a, 171 65 Solna, Karolinska Institutet, Stockholm, Sweden. 5. Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Stockholm Sweden. 6. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University Hospital and Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden; Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
Abstract
BACKGROUND: Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis. OBJECTIVE: To explore incident infections in MS, stratified by age and sex. METHODS: In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome. RESULTS: The IRRs were 2.54 (95% CI 2.28-2.83) for first serious infection and 1.61 (1.52-1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24-2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date. CONCLUSION: The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.
BACKGROUND:Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis. OBJECTIVE: To explore incident infections in MS, stratified by age and sex. METHODS: In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome. RESULTS: The IRRs were 2.54 (95% CI 2.28-2.83) for first serious infection and 1.61 (1.52-1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24-2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date. CONCLUSION: The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.
Authors: Lutz Achtnichts; Barbara Jakopp; Michael Oberle; Krassen Nedeltchev; Christoph Andreas Fux; Johann Sellner; Oliver Findling Journal: Vaccines (Basel) Date: 2021-12-11
Authors: Stephen L Hauser; Ludwig Kappos; Xavier Montalban; Licinio Craveiro; Cathy Chognot; Richard Hughes; Harold Koendgen; Noemi Pasquarelli; Ashish Pradhan; Kalpesh Prajapati; Jerry S Wolinsky Journal: Neurology Date: 2021-09-02 Impact factor: 9.910