The B-cell–depleting treatment rituximab was associated with a twofold increased risk for infection in RRMS, regardless of treatment duration or whether the patient had received other DMTs first.
, regardless of treatment duration or whether patients had received other disease-modifying therapy or had a short disease duration.
However, although new treatment options offer stronger suppression of MS inflammatory disease activity than old DMTs, they may also be associated with treatment-related risks — particularly infection. The Swedish MS registry study included 4694 individuals aged 18 years or older with RRMS who initiated rituximab treatment from January 1, 2012, to June 30, 2021. Infection rates in this group were compared with those of 6049 patients treated with other DMTs and 20,308 age- and sex-matched MS-free control participants who were included to further benchmark infection rates.
Most of the findings remained similar in a sensitivity analysis that censored follow-up on February 29, 2020, to exclude a potential bias introduced by the COVID-19 pandemic.Although the incidence rates for serious infections were somewhat reduced and rates of antibiotic prescriptions increased, the differences between rituximab and the other DMTs remained similar.
The study's limitations included lack of data on tobacco-smoking status, although Sweden has a"very low rate" of daily smokers, so the impact is"likely to be small." The researchers also did not analyze cumulative dose or dosing intervals, although a"large majority" could be expected to have been exposed to biannual infusions with 500 mg of rituximab, at least until the outbreak of COVID-19.
Multiple Sclerosis MS MS - Multiple Sclerosis Antineoplastic Drug Anti-Cancer Agents Erlotinib Gefitinib Imatinib Rituximab Su11248 Sunitinib Trastuzumab Monoclonal Antibody Cetuximab Rituximab Biologic Therapy Biologics COVID-19 2019 Novel Coronavirus 2019-Ncov Wuhan Coronavirus Human Coronavirus HKU1 Human Coronavirus OC43 Hcov-OC43
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