Review
Clinical Neurology
Isabella Laura Simone, Carla Tortorella, Alma Ghirelli
Summary: Multiple sclerosis predominantly affects young women, impacting fertility, pregnancy, fetal outcome, and breastfeeding. The use of disease-modifying therapies has changed the natural history of the disease and perspectives on pregnancy.
FRONTIERS IN NEUROLOGY
(2021)
Review
Clinical Neurology
Fioravante Capone, Angela Albanese, Giorgia Quadri, Vincenzo Di Lazzaro, Emma Falato, Antonio Cortese, Laura De Giglio, Elisabetta Ferraro
Summary: Pregnancy-related issues and the use of disease-modifying therapies (DMTs) during pregnancy and breastfeeding in women with multiple sclerosis (MS) need to be carefully considered. Breastfeeding has benefits for both infants and mothers, but its protective role in MS is still debated. The potential transfer of DMTs into breastmilk and the resulting exposure to infants is a concern, leading to a difficult choice between breastfeeding and DMT resumption.
FRONTIERS IN NEUROLOGY
(2022)
Review
Clinical Neurology
Francesca Washington, Dawn Langdon
Summary: Research shows that patients with multiple sclerosis often struggle with treatment adherence, influenced by factors such as age, gender, emotions, cognition, and treatment satisfaction. Targeted patient support programs should be developed to improve treatment compliance.
JOURNAL OF NEUROLOGY
(2022)
Review
Pharmacology & Pharmacy
Peter Alping
Summary: This study aimed to summarize the current evidence for rituximab as a treatment for relapsing-remitting MS (RRMS).
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
(2023)
Review
Immunology
Georges Jalkh, Rachelle Abi Nahed, Gabrielle Macaron, Mary Rensel
Summary: In the past decade, the therapeutic options for multiple sclerosis have greatly expanded, with newer and more effective disease modifying therapies being increasingly used early in the disease course. Despite their advantages in controlling disease activity and improving long-term outcomes, these newer therapies come with safety concerns and monitoring requirements that highlight the need for periodic re-evaluation and adjustment of monitoring strategies for optimizing treatment safety in an individualized manner.
Review
Clinical Neurology
Ruth Dobson, Kerstin Hellwig
Summary: MS predominantly affects women, with decreasing age at diagnosis and complex treatment options, more women are facing decisions about disease modifying therapy during and around pregnancy. New data on the safety of therapies during pregnancy and breastfeeding are emerging rapidly. Effective treatment and suppression of relapses is crucial for ensuring good outcomes in the longer term for women.
CURRENT OPINION IN NEUROLOGY
(2021)
Article
Clinical Neurology
Steve Simpson-Yap, Edward De Brouwer, Tomas Kalincik, Nick Rijke, Jan A. Hillert, Clare Walton, Gilles Edan, Yves Moreau, Tim Spelman, Lotte Geys, Tina Parciak, Clement Gautrais, Nikola Lazovski, Ashkan Pirmani, Amin Ardeshirdavanai, Lars Forsberg, Anna Glaser, Robert McBurney, Hollie Schmidt, Arnfin B. Bergmann, Stefan Braune, Alexander Stahmann, Rodden Middleton, Amber Salter, Robert J. Fox, Anneke van der Walt, Helmut Butzkueven, Raed Alroughani, Serkan Ozakbas, Juan Rojas, Ingrid van der Mei, Nupur Nag, Rumen Ivanov, Guilherme Sciascia do Olival, Alice Estavo Dias, Melinda Magyari, Doralina Brum, Maria Fernanda Mendes, Ricardo N. Alonso, Richard S. Nicholas, Johana Bauer, Anibal Sebastian Chertcoff, Anna Zabalza, Georgina Arrambide, Alexander Fidao, Giancarlo Comi, Liesbet Peeters
Summary: Using data from 12 sources in 28 countries, this study examined the characteristics of COVID-19 severity in people with MS, particularly those taking immunosuppressive therapies. The results showed that older age, progressive MS phenotype, and higher disability were associated with worse COVID-19 outcomes. Additionally, rituximab was consistently associated with increased risk of hospitalization, ICU admission, and need for ventilation, while ocrelizumab was mainly associated with hospitalization and ICU admission.
Article
Immunology
Zhuoyi Liu, Qiao Liao, Haicheng Wen, Yihao Zhang
Summary: This study compared the efficacy and compliance of up-to-date disease modifying therapies in patients with relapsing-remitting multiple sclerosis. Ofatumumab, alemtuzumab, and natalizumab showed superior effectiveness and compliance in treating RRMS. Further studies are needed to explore the long-term effects of DMTs.
AUTOIMMUNITY REVIEWS
(2021)
Article
Chemistry, Medicinal
Liberata Sportiello, Raffaella Di Napoli, Nunzia Balzano, Annamaria Mascolo, Rosanna Ruggiero, Luigi Di Costanzo, Davida Monaco, Giorgia Teresa Maniscalco, Annalisa Capuano
Summary: This study compared the safety profiles of different drugs in pregnant and lactating women with multiple sclerosis. The study found that there were more adverse drug reactions unrelated to pregnancy and breastfeeding, and the most common adverse reaction related to pregnancy and breastfeeding was spontaneous abortion. Natalizumab and ocrelizumab were associated with a higher reporting probability of spontaneous abortion, while alemtuzumab had a lower reporting frequency.
Review
Immunology
Veronica Cabreira, Pedro Abreu, Ricardo Soares-dos-Reis, Joana Guimaraes, Maria Jose Sa
Summary: Most MS patients receiving DMTs do not have a higher risk of severe COVID-19, but factors like age, comorbidities, and disability can significantly impact outcomes. While most DMTs have minimal influence on COVID-19, therapies causing severe lymphopenia and hypogammaglobulinemia, like anti-CD20 therapies, may lead to increased hospitalization, worse outcomes, and higher reinfection risk.
Review
Chemistry, Medicinal
Panagiotis Gklinos, Ruth Dobson
Summary: The use of high-efficacy disease-modifying therapies (DMTs) early in the course of multiple sclerosis (MS) has been proven effective. Monoclonal antibodies, such as natalizumab, alemtuzumab, ocrelizumab, ofatumumab, and ublituximab, are commonly used in the treatment of MS in women of childbearing age. However, limited evidence is available on their use during pregnancy. It is important to discuss treatment options and family planning with patients before starting a DMT.
Article
Clinical Neurology
Anthony T. Reder, Diego Centonze, Maria L. Naylor, Anjali Nagpal, Rajani Rajbhandari, Arman Altincatal, Michelle Kim, Aaron Berdofe, Maha Radhakrishnan, Eunice Jung, Alfred W. Sandrock, Karen Smirnakis, Catrinel Popescu, Carl de Moor
Summary: The study revealed that comorbidities, obesity, and Black/African ancestry were major risk factors for SARS-CoV-2 infection in patients with multiple sclerosis (PwMS). It also found that interferons and glatiramer acetate were associated with reduced COVID-19 risk, while anti-CD20 therapies were linked to increased risk within the treated MS cohort.
Review
Clinical Neurology
Masoud Etemadifar, Hosein Nouri, Maristella Pitzalis, Maria Laura Idda, Mehri Salari, Mahshid Baratian, Sepide Mahdavi, Amir Parsa Abhari, Nahad Sedaghat
Summary: Studies have shown that patients with multiple sclerosis receiving disease-modifying therapies may have lower immune response after COVID-19 vaccination. B-cell depletion therapies may accelerate post-vaccination antibody waning. Real-world data suggests that patients receiving certain therapies have higher incidence and severity of breakthrough COVID-19. Therefore, optimizing immune response and ensuring its durability are necessary in the COVID-19 vaccination policy for these patients.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2022)
Review
Clinical Neurology
Karolina Kania, Wojciech Ambrosius, Wojciech Kozubski, Alicja Kalinowska-Lyszczarz
Summary: In recent decades, clinicians have recognized that cognitive impairment is a major cause of disability, loss of employment, and poor quality of life in multiple sclerosis patients. The impact of disease-modifying therapies on cognition is still uncertain. This study aimed to review the evidence regarding the effect of these therapies on cognitive functions.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Diego Centonze, Maria A. Rocca, Claudio Gasperini, Ludwig Kappos, Hans-Peter Hartung, Melinda Magyari, Celia Oreja-Guevara, Maria Trojano, Heinz Wiendl, Massimo Filippi
Summary: COVID-19 emerged in Wuhan, China in December 2019 and quickly spread globally, with over 132 million cases and 2.8 million deaths recorded to date. A massive vaccination campaign has been initiated worldwide since the end of 2020, although there are concerns among neurologists about the safety and efficacy of vaccination in multiple sclerosis patients on immunomodulatory or immunosuppressive therapies.
JOURNAL OF NEUROLOGY
(2021)