Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies.
Adverse events
Disease-modifying therapy
Infections
Multiple sclerosis
Risk mitigation
Treatment
Journal
Current neurology and neuroscience reports
ISSN: 1534-6293
Titre abrégé: Curr Neurol Neurosci Rep
Pays: United States
ID NLM: 100931790
Informations de publication
Date de publication:
19 05 2021
19 05 2021
Historique:
accepted:
22
04
2021
entrez:
19
5
2021
pubmed:
20
5
2021
medline:
25
5
2021
Statut:
epublish
Résumé
The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)-orals and monoclonals-have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies. We classify risk mitigation strategies according to the following framework: (1) screening and patient selection, (2) vaccinations, (3) antibiotic prophylaxis, (4) laboratory and MRI monitoring, (5) adjusting dose and frequency of DMT, and (6) behavioral modifications to limit the risk of infection. We systematically apply this framework to the infections for which risk mitigations are available: hepatitis B, herpetic infections, progressive multifocal leukoencephalopathy, and tuberculosis. We also discuss up-to-date recommendations regarding COVID-19 vaccinations for patients on DMTs. We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies.
Identifiants
pubmed: 34009478
doi: 10.1007/s11910-021-01117-y
pii: 10.1007/s11910-021-01117-y
pmc: PMC8132488
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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