Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies
Purpose of Review The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)—orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of ser...
Gespeichert in:
| Veröffentlicht in: | Current neurology and neuroscience reports 2021-07, Vol.21 (7), p.36, Article 36 |
|---|---|
| Hauptverfasser: | , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 7 |
| container_start_page | 36 |
| container_title | Current neurology and neuroscience reports |
| container_volume | 21 |
| creator | Smith, Tyler Ellis Kister, Ilya |
| description | Purpose of Review
The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)—orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies.
Recent Findings
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.
Summary
We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies. |
| doi_str_mv | 10.1007/s11910-021-01117-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8132488</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2529015697</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f2edb257f4332a6770d987e39aa5401bbfe24a7aa931945563e38340ae2a29ba3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi1ERUvhD3BAlrhwMfVX4viChMpXpa6K1HK2JskkdZW1FzuptP8ed7eUlgMnjzXPvPPxEvJG8A-Cc3OShbCCMy4F40IIw7bPyJGolGa1tOr5XSwbprmWh-Rlzjecy1JmX5BDpTm32jRHJJ2FAbvZx0BXfvYj7MLLOcGMo8dMh5joaplmv5mQXnYTpph9pj8KiGHOtNAXCSYKoaerGGI3xVC-n31GyMhWsffD1oeRXl1jgk2RfEUOBpgyvr5_j8nPr1-uTr-z84tvZ6efzlmnjZ7ZILFvZWUGrZSE2hje28agsgCV5qJtB5QaDIBVwuqqqhWqpiwGKEHaFtQx-bjX3SztGvuujFsGdZvk15C2LoJ3TzPBX7sx3rpGKKmbpgi8vxdI8deCeXZrnzucJggYl-xkOa_ldd3ogr77B72JSyqH2FGWi6q2plByT3XliDnh8DCM4O7OUre31BVL3c5Sty1Fbx-v8VDyx8MCqD2QSyqMmP72_o_sbxRKrtw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2529015697</pqid></control><display><type>article</type><title>Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Smith, Tyler Ellis ; Kister, Ilya</creator><creatorcontrib>Smith, Tyler Ellis ; Kister, Ilya</creatorcontrib><description>Purpose of Review
The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)—orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies.
Recent Findings
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.
Summary
We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies.</description><identifier>ISSN: 1528-4042</identifier><identifier>ISSN: 1534-6293</identifier><identifier>EISSN: 1534-6293</identifier><identifier>DOI: 10.1007/s11910-021-01117-y</identifier><identifier>PMID: 34009478</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>COVID-19 ; Hepatitis B ; Humans ; Immunization ; Immunomodulation ; Immunosuppressive Agents - adverse effects ; Infections ; Leukoencephalopathy ; Magnetic resonance imaging ; Medicine ; Medicine & Public Health ; Multiple sclerosis ; Multiple Sclerosis - drug therapy ; Neurology ; Neurology of Systemic Diseases (J. Biller ; Neurology of Systemic Diseases (J. Biller, Section Editor) ; Neurosciences ; Progressive multifocal leukoencephalopathy ; Prophylaxis ; SARS-CoV-2 ; Section Editor ; Topical Collection on Neurology of Systemic Disease ; Tuberculosis</subject><ispartof>Current neurology and neuroscience reports, 2021-07, Vol.21 (7), p.36, Article 36</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f2edb257f4332a6770d987e39aa5401bbfe24a7aa931945563e38340ae2a29ba3</citedby><cites>FETCH-LOGICAL-c474t-f2edb257f4332a6770d987e39aa5401bbfe24a7aa931945563e38340ae2a29ba3</cites><orcidid>0000-0001-6836-8192 ; 0000-0003-3549-949X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11910-021-01117-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11910-021-01117-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34009478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, Tyler Ellis</creatorcontrib><creatorcontrib>Kister, Ilya</creatorcontrib><title>Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies</title><title>Current neurology and neuroscience reports</title><addtitle>Curr Neurol Neurosci Rep</addtitle><addtitle>Curr Neurol Neurosci Rep</addtitle><description>Purpose of Review
The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)—orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies.
Recent Findings
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.
Summary
We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies.</description><subject>COVID-19</subject><subject>Hepatitis B</subject><subject>Humans</subject><subject>Immunization</subject><subject>Immunomodulation</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Infections</subject><subject>Leukoencephalopathy</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - drug therapy</subject><subject>Neurology</subject><subject>Neurology of Systemic Diseases (J. Biller</subject><subject>Neurology of Systemic Diseases (J. Biller, Section Editor)</subject><subject>Neurosciences</subject><subject>Progressive multifocal leukoencephalopathy</subject><subject>Prophylaxis</subject><subject>SARS-CoV-2</subject><subject>Section Editor</subject><subject>Topical Collection on Neurology of Systemic Disease</subject><subject>Tuberculosis</subject><issn>1528-4042</issn><issn>1534-6293</issn><issn>1534-6293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1v1DAQhi1ERUvhD3BAlrhwMfVX4viChMpXpa6K1HK2JskkdZW1FzuptP8ed7eUlgMnjzXPvPPxEvJG8A-Cc3OShbCCMy4F40IIw7bPyJGolGa1tOr5XSwbprmWh-Rlzjecy1JmX5BDpTm32jRHJJ2FAbvZx0BXfvYj7MLLOcGMo8dMh5joaplmv5mQXnYTpph9pj8KiGHOtNAXCSYKoaerGGI3xVC-n31GyMhWsffD1oeRXl1jgk2RfEUOBpgyvr5_j8nPr1-uTr-z84tvZ6efzlmnjZ7ZILFvZWUGrZSE2hje28agsgCV5qJtB5QaDIBVwuqqqhWqpiwGKEHaFtQx-bjX3SztGvuujFsGdZvk15C2LoJ3TzPBX7sx3rpGKKmbpgi8vxdI8deCeXZrnzucJggYl-xkOa_ldd3ogr77B72JSyqH2FGWi6q2plByT3XliDnh8DCM4O7OUre31BVL3c5Sty1Fbx-v8VDyx8MCqD2QSyqMmP72_o_sbxRKrtw</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Smith, Tyler Ellis</creator><creator>Kister, Ilya</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6836-8192</orcidid><orcidid>https://orcid.org/0000-0003-3549-949X</orcidid></search><sort><creationdate>20210701</creationdate><title>Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies</title><author>Smith, Tyler Ellis ; Kister, Ilya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f2edb257f4332a6770d987e39aa5401bbfe24a7aa931945563e38340ae2a29ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>COVID-19</topic><topic>Hepatitis B</topic><topic>Humans</topic><topic>Immunization</topic><topic>Immunomodulation</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Infections</topic><topic>Leukoencephalopathy</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - drug therapy</topic><topic>Neurology</topic><topic>Neurology of Systemic Diseases (J. Biller</topic><topic>Neurology of Systemic Diseases (J. Biller, Section Editor)</topic><topic>Neurosciences</topic><topic>Progressive multifocal leukoencephalopathy</topic><topic>Prophylaxis</topic><topic>SARS-CoV-2</topic><topic>Section Editor</topic><topic>Topical Collection on Neurology of Systemic Disease</topic><topic>Tuberculosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, Tyler Ellis</creatorcontrib><creatorcontrib>Kister, Ilya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Current neurology and neuroscience reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, Tyler Ellis</au><au>Kister, Ilya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies</atitle><jtitle>Current neurology and neuroscience reports</jtitle><stitle>Curr Neurol Neurosci Rep</stitle><addtitle>Curr Neurol Neurosci Rep</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>21</volume><issue>7</issue><spage>36</spage><pages>36-</pages><artnum>36</artnum><issn>1528-4042</issn><issn>1534-6293</issn><eissn>1534-6293</eissn><abstract>Purpose of Review
The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)—orals and monoclonals—have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies.
Recent Findings
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.
Summary
We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34009478</pmid><doi>10.1007/s11910-021-01117-y</doi><orcidid>https://orcid.org/0000-0001-6836-8192</orcidid><orcidid>https://orcid.org/0000-0003-3549-949X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1528-4042 |
| ispartof | Current neurology and neuroscience reports, 2021-07, Vol.21 (7), p.36, Article 36 |
| issn | 1528-4042 1534-6293 1534-6293 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8132488 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | COVID-19 Hepatitis B Humans Immunization Immunomodulation Immunosuppressive Agents - adverse effects Infections Leukoencephalopathy Magnetic resonance imaging Medicine Medicine & Public Health Multiple sclerosis Multiple Sclerosis - drug therapy Neurology Neurology of Systemic Diseases (J. Biller Neurology of Systemic Diseases (J. Biller, Section Editor) Neurosciences Progressive multifocal leukoencephalopathy Prophylaxis SARS-CoV-2 Section Editor Topical Collection on Neurology of Systemic Disease Tuberculosis |
| title | Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T19%3A48%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Infection%20Mitigation%20Strategies%20for%20Multiple%20Sclerosis%20Patients%20on%20Oral%20and%20Monoclonal%20Disease-Modifying%20Therapies&rft.jtitle=Current%20neurology%20and%20neuroscience%20reports&rft.au=Smith,%20Tyler%20Ellis&rft.date=2021-07-01&rft.volume=21&rft.issue=7&rft.spage=36&rft.pages=36-&rft.artnum=36&rft.issn=1528-4042&rft.eissn=1534-6293&rft_id=info:doi/10.1007/s11910-021-01117-y&rft_dat=%3Cproquest_pubme%3E2529015697%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2529015697&rft_id=info:pmid/34009478&rfr_iscdi=true |