Therapeutic consequences in patients with both inflammatory rheumatic diseases and multiple sclerosis.

Dealing with patients with both multiple sclerosis (MS) and inflammatory rheumatic disorders (IRD) is not uncommon for a rheumatologist, as there is a statistical association between spondyloarthritis and MS. As several central nervous system demyelinating events have been reported in patients treated with TNFi, the pre-existing demyelinating disease was considered a contraindication for TNFi. However, this contraindication is mainly based on a randomized controlled trial in MS and not on large epidemiologic studies. According to the last epidemiologic studies, TNFi might not be inducer of MS. Moreover, there are no clear recommendations on the use of the other DMARDs in patients suffering from an IRD and MS. In this review, we summarize the link between MS and the IRD and the impact of DMARDs on MS, especially TNFi. We also look at the impact of disease-modifying drugs for adults with MS on IRD.