Infection Risk with B-cell Depletion in Multiple Sclerosis
Author Information
Author(s): Suvi Virtanen, Fredrik Piehl, Thomas Frisell
Primary Institution: Karolinska Institutet, Stockholm, Sweden
Hypothesis
How do previous treatment history and B-cell depletion treatment duration affect infection risk in relapsing-remitting multiple sclerosis?
Conclusion
B-cell depletion treatment in relapsing-remitting multiple sclerosis is associated with a doubled risk of serious infections, regardless of treatment history or duration.
Supporting Evidence
- Patients on rituximab had a higher incidence of serious infections compared to those on other treatments.
- The risk of infection did not vary significantly with treatment duration or previous treatment history.
- Serious infections were recorded more frequently in rituximab cohorts than in other DMT groups.
Takeaway
This study found that patients with multiple sclerosis who take a specific treatment called rituximab have a higher chance of getting serious infections, even if they haven't taken other treatments before.
Methodology
A nationwide cohort study using data from the Swedish MS registry and national health registries to compare infection rates among patients on different treatments.
Potential Biases
Potential bias due to the COVID-19 pandemic affecting follow-up data.
Limitations
Lack of data on tobacco smoking status and laboratory data such as immunoglobulin levels.
Participant Demographics
Participants included 10,743 patients with relapsing-remitting multiple sclerosis, with a mean age of 39.6 years and a majority being female.
Statistical Information
P-Value
0.001
Confidence Interval
95% CI 8.1 to 12.9
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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