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Infections in patients with multiple sclerosis: A national cohort study in Sweden
•Large population-based study on incident infections in MS patients.•Increased risk of incident serious/non-serious infections in MS patients.•Highest risk for urinary tract/kidney infections.•Increased risk included risk especially for respiratory/throat infections and pneumonia/influenza. Multiple...
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| Published in: | Multiple sclerosis and related disorders 2020-10, Vol.45, p.102420-102420, Article 102420 |
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| container_end_page | 102420 |
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| container_title | Multiple sclerosis and related disorders |
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| creator | Castelo-Branco, Anna Chiesa, Flaminia Conte, Simona Bengtsson, Camilla Lee, Sally Minton, Neil Niemcryk, Steve Lindholm, Anders Rosenlund, Mats Piehl, Fredrik Montgomery, Scott |
| description | •Large population-based study on incident infections in MS patients.•Increased risk of incident serious/non-serious infections in MS patients.•Highest risk for urinary tract/kidney infections.•Increased risk included risk especially for respiratory/throat infections and pneumonia/influenza.
Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.
To explore incident infections in MS, stratified by age and sex.
In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.
The IRRs were 2.54 (95% CI 2.28–2.83) for first serious infection and 1.61 (1.52–1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24–2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to |
| doi_str_mv | 10.1016/j.msard.2020.102420 |
| format | article |
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Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.
To explore incident infections in MS, stratified by age and sex.
In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.
The IRRs were 2.54 (95% CI 2.28–2.83) for first serious infection and 1.61 (1.52–1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24–2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date.
The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.</description><identifier>ISSN: 2211-0348</identifier><identifier>ISSN: 2211-0356</identifier><identifier>EISSN: 2211-0356</identifier><identifier>DOI: 10.1016/j.msard.2020.102420</identifier><identifier>PMID: 32736217</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Cohort Studies ; Cohort study ; Comorbidities ; Health registers ; Humans ; Incidence ; Infections ; Medicin och hälsovetenskap ; Multiple sclerosis ; Multiple Sclerosis - epidemiology ; Risk Assessment ; Risk Factors ; Sweden - epidemiology</subject><ispartof>Multiple sclerosis and related disorders, 2020-10, Vol.45, p.102420-102420, Article 102420</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-7c5a924400fcd9ac3de5bd7e0a41d583a61139779288bc516c7c7a6e649e569c3</citedby><cites>FETCH-LOGICAL-c529t-7c5a924400fcd9ac3de5bd7e0a41d583a61139779288bc516c7c7a6e649e569c3</cites><orcidid>0000-0001-8329-5219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32736217$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-84776$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:144992150$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Castelo-Branco, Anna</creatorcontrib><creatorcontrib>Chiesa, Flaminia</creatorcontrib><creatorcontrib>Conte, Simona</creatorcontrib><creatorcontrib>Bengtsson, Camilla</creatorcontrib><creatorcontrib>Lee, Sally</creatorcontrib><creatorcontrib>Minton, Neil</creatorcontrib><creatorcontrib>Niemcryk, Steve</creatorcontrib><creatorcontrib>Lindholm, Anders</creatorcontrib><creatorcontrib>Rosenlund, Mats</creatorcontrib><creatorcontrib>Piehl, Fredrik</creatorcontrib><creatorcontrib>Montgomery, Scott</creatorcontrib><title>Infections in patients with multiple sclerosis: A national cohort study in Sweden</title><title>Multiple sclerosis and related disorders</title><addtitle>Mult Scler Relat Disord</addtitle><description>•Large population-based study on incident infections in MS patients.•Increased risk of incident serious/non-serious infections in MS patients.•Highest risk for urinary tract/kidney infections.•Increased risk included risk especially for respiratory/throat infections and pneumonia/influenza.
Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.
To explore incident infections in MS, stratified by age and sex.
In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.
The IRRs were 2.54 (95% CI 2.28–2.83) for first serious infection and 1.61 (1.52–1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24–2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date.
The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cohort Studies</subject><subject>Cohort study</subject><subject>Comorbidities</subject><subject>Health registers</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Medicin och hälsovetenskap</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - epidemiology</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sweden - epidemiology</subject><issn>2211-0348</issn><issn>2211-0356</issn><issn>2211-0356</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kV1rFDEUhgdRbKn9BYLMpRfONt-ZCF4srR-FgogftyGbnLVZZyZjknHpvzfjbLdXNRByODzvOZCnql5itMIIi4vdqk8muhVBZO4QRtCT6pQQjBtEuXh6rFl7Up2ntEPlCI6ZwM-rE0okFQTL0-rL9bAFm30YUu2HejTZw5BTvff5tu6nLvuxgzrZDmJIPr2t1_VgZtx0tQ23IeY65cndzeGve3AwvKiebU2X4PzwnlXfP7z_dvmpufn88fpyfdNYTlRupOVGEcYQ2lqnjKUO-MZJQIZhx1tqBMZUSalI224sx8JKK40AwRRwoSw9q5plbtrDOG30GH1v4p0OxutD61epQDOhiGoLrx7lxxjcQ-g-iBlTimCOSvbNo9kr_2OtQ_xZ7qRbJqUo-OsFL3N_T5Cy7n2y0HVmgDAlXWwp2bZS0oLSBbXlf1OE7XE2Rno2rXf6n2k9m9aL6ZJ6dVgwbXpwx8y91wK8WwAoBv54iDrZItaC87Ho1i74_y74C37Tu_Y</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Castelo-Branco, Anna</creator><creator>Chiesa, Flaminia</creator><creator>Conte, Simona</creator><creator>Bengtsson, Camilla</creator><creator>Lee, Sally</creator><creator>Minton, Neil</creator><creator>Niemcryk, Steve</creator><creator>Lindholm, Anders</creator><creator>Rosenlund, Mats</creator><creator>Piehl, Fredrik</creator><creator>Montgomery, Scott</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><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>7X8</scope><scope>AABEP</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D91</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0001-8329-5219</orcidid></search><sort><creationdate>20201001</creationdate><title>Infections in patients with multiple sclerosis: A national cohort study in Sweden</title><author>Castelo-Branco, Anna ; 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Multiple sclerosis (MS) patients have an increased risk of infections, but few population-based studies have reported infections occurring in MS in the years immediately after diagnosis.
To explore incident infections in MS, stratified by age and sex.
In a Swedish population-based cohort study 6602 incident MS patients (aged ≥18 years), matched at diagnosis with 61,828 matched MS-free individuals were identified between 1st January 2008 and 31st December 2016, using national registers. Incidence rates (IR) and incidence rate ratios (IRR) with 95% CI were calculated for each outcome.
The IRRs were 2.54 (95% CI 2.28–2.83) for first serious infection and 1.61 (1.52–1.71) for first non-serious infection. Compared with MS-free individuals, MS patients had higher IRs for skin, respiratory/throat infections, pneumonia/influenza, bacterial, viral, and fungal infections, with the highest IRR observed for urinary tract/kidney infections (2.44; 2.24–2.66). The cumulative incidence for most of these infections was higher among MS patients than MS-free individuals, both 0 to <5 and 5 to <9 years after index date.
The burden of infections around the time of MS diagnosis and subsequent infection risk, underscore the need for careful considerations regarding the risk-benefit across different disease-modifying therapies.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>32736217</pmid><doi>10.1016/j.msard.2020.102420</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-8329-5219</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Multiple sclerosis and related disorders, 2020-10, Vol.45, p.102420-102420, Article 102420 |
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| language | eng |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Adolescent Adult Cohort Studies Cohort study Comorbidities Health registers Humans Incidence Infections Medicin och hälsovetenskap Multiple sclerosis Multiple Sclerosis - epidemiology Risk Assessment Risk Factors Sweden - epidemiology |
| title | Infections in patients with multiple sclerosis: A national cohort study in Sweden |
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