by Patricia Valerio, PhD | October 20, 2022
People with progressive forms of multiple sclerosis (MS) are nearly four times more likely to have serious infections — those leading to hospitalization — than those with relapsing-remitting MS (RRMS), according to a large study in Germany.
This higher infection risk was found despite the fact that, during the study period, most RRMS patients — but less than one-third of those with progressive MS forms — received disease-modifying therapies (DMTs), which typically suppress the immune system.
Older age and male sex also were associated with a significantly higher rate of infection-related hospitalizations among MS patients, the study found. Respiratory infections and those of the urinary tract and reproductive organs were most commonly reported serious infections.
The study, “Serious infections in patients with relapsing and progressive forms of multiple sclerosis: a German claims data study,” was published in Multiple Sclerosis and Related Disorders. The work was supported by Roche.
In people with MS, infections are a common cause of comorbidity, or the presence of more than one disease or condition at the same time. Having co-existing diseases can negatively impact health outcomes.
Real-world studies have shown that MS patients are at a higher risk of developing serious infections, or those leading to hospitalization, than those without the autoimmune disease.
Disease type and infection risk
“The risk of intensive care unit admission is also higher in PwMS [people with MS] in association with infections,” the researchers wrote, adding that “infections, in particular those of respiratory and urinary origin, are a common cause of mortality in MS.”
The use of disease-modifying therapies or DMTs — the majority of which work by suppressing the immune system — is common in MS and has been linked to an increased risk of serious infections. Researchers have suggested, however, that other factors, such as age, sex, and MS type, also might contribute to a higher susceptibility to infections.
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But “few real-world studies have explored the risk of serious infections (SIs) associated with these factors,” the researchers wrote.
Now, a team of researchers in Germany and Switzerland compared the occurrence of these infections among people with RRMS, primary progressive MS (PPMS), and secondary progressive MS (SPMS).
The researchers retrospectively analyzed administrative claims data from 4,250 adults diagnosed with MS in Germany from 2016 to 2018. All patients had available data one year before and after their diagnosis.
More than half of patients — 2,307 or 54.3% — had RRMS, while 282 (6.6%) were diagnosed with PPMS, and 558 (13.1%) had SPMS. The MS type was unspecified for 1,135 patients (26.7%).
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