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Infections in Patients Receiving Multiple Sclerosis Disease-Modifying Therapies

  • Infection (J Halperin, Section Editor)
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Abstract

Purpose of Review

This paper will systemically review the risk of infections associated with current disease-modifying treatments and will discuss pre-treatment testing recommendations, infection monitoring strategies, and patient education.

Recent Findings

Aside from glatiramer acetate and interferon-beta therapies, all other multiple sclerosis treatments to various degrees impair immune surveillance and may predispose patients to the development of both community-acquired and opportunistic infections. Some of these infections are rarely seen in neurologic practice, and neurologists should be aware of how to monitor for these infections and how to educate patients about medication-specific risks. Of particular interest in this discussion is the risk of PML in association with the recently approved B cell depleting therapy, ocrelizumab, particularly when switching from natalizumab.

Summary

The risk of infection in association with MS treatments has become one of the most important factors in the choice of therapy. Balance of the overall risk versus benefit should be continuously re-evaluated during treatment.

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Authors and Affiliations

  1. Multiple Sclerosis Division, Davee Department of Neurology and Clinical Neurosciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Elena Grebenciucova

  2. Multiple Sclerosis Division, the Department of Neurology, Perelman School of Medicine, The University of Pennsylvania, 3400 Convention Avenue, Philadelphia, PA, 19104, USA

    Amy Pruitt

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Amy Pruitt declares no conflict of interest.

Elena Grebenciucova has received James T. Lubin Clinician Scientist Fellowship Award from the Transverse Myelitis Association dedicated to promising research and exceptional clinical care for rare neuro-immune disorders, such as transverse myelitis, including acute flaccid myelitis, acute disseminated encephalomyelitis, neuromyelitis optica, and optic neuritis.

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Grebenciucova, E., Pruitt, A. Infections in Patients Receiving Multiple Sclerosis Disease-Modifying Therapies. Curr Neurol Neurosci Rep 17, 88 (2017). https://doi.org/10.1007/s11910-017-0800-8

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  • DOI: https://doi.org/10.1007/s11910-017-0800-8

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