Certain MS Drugs Tied to Increased Infection Risk

Treatment with natalizumab for multiple sclerosis (MS) are associated with an increased risk of infection, according to a new study.

For their study, the researchers evaluated administrative data on 6793 MS cases from the time of their first demyelinating events (1996 to 2013) until emigration, death, or the end of the study in December 2013.
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Recurrent time-to-event models were used to examine relationships between DMT exposure and infection-related physician or hospital claims. Results were adjusted for various demographic factors and reported as adjusted HRs (aHRs).

A total of 1716 (25%) MS cases were DMT-exposed. Findings revealed that exposure to any first-generation DMT such as beta-interferon or glatiramer acetate was not associated with infection-related physician claims (aHR 0.96), compared with no DMT exposure.

Exposure to any second-generation DMT such as oral DMTs or natalizumab was associated with an increased risk of an infection-related physician claim (aHR 1.47). However, when analyzed individually, this association was found to be significant for natalizumab (aHR 1.59) but not oral DMTs (aHR 1.17).

The researchers noted that, although no DMTs were associated with infection-related hospital claims, these hospitalizations were uncommon.

“Exposure to first-generation DMTs was not associated with an altered infection risk,” the researchers wrote. “However, exposure to the second-generation DMTs was, with natalizumab associated with a 59% increased risk of an infection-related physician claim.”

“Continued pharmacovigilance is warranted, including an investigation of the DMT-associated infection burden on patient outcomes,” they concluded.

—Christina Vogt

Reference:

Wijnands JMA, Zhu F, Kingwell E, et al. Disease-modifying drugs for multiple sclerosis and infection risk: a cohort study [Published online March 30, 2018]. Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2017-317493.