Infections in patients with multiple sclerosis: A national cohort study in Sweden.
Cohort study
Comorbidities
Health registers
Incidence
Infections
Multiple sclerosis
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
29
04
2020
revised:
08
07
2020
accepted:
22
07
2020
pubmed:
1
8
2020
medline:
15
5
2021
entrez:
1
8
2020
Statut:
ppublish
Résumé
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. To explore incident infections in MS, stratified by age and sex. 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. 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
To explore incident infections in MS, stratified by age and sex.
METHODS
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 32736217
pii: S2211-0348(20)30495-8
doi: 10.1016/j.msard.2020.102420
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102420Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article:SM has received research funding from Roche, Novartis and AstraZeneca, a speaker's fee from Teva and is a member of a study advisory board with IQVIA (this study). FP has received research grants from Genzyme, Merck KGaA and Novartis, and fees for serving as Chair of DMC in clinical trials with Parexel. SL, NM, SN and AL are employees of Celgene (now Bristol-Myer Squibb) and own company stock. ACB, SC, FC, MR and CB were consultants to Celgene through their employment at IQVIA at the time of the study.