Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies.
Tyler Ellis SmithIlya KisterPublished in: Current neurology and neuroscience reports (2021)
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.
Keyphrases
- multiple sclerosis
- end stage renal disease
- chronic kidney disease
- ejection fraction
- newly diagnosed
- coronavirus disease
- climate change
- peritoneal dialysis
- prognostic factors
- emergency department
- mycobacterium tuberculosis
- case report
- mass spectrometry
- computed tomography
- ms ms
- hepatitis c virus
- multiple myeloma
- drug induced
- contrast enhanced
- pulmonary tuberculosis
- adverse drug
- respiratory syndrome coronavirus