Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands.
Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2022 Oct;28(11):1808-1818. doi: 10.1177/13524585221094218. Epub 2022 May 14.
People with multiple sclerosis (pwMS) have an increased risk of infections; risk factors include underlying disease, physical impairment and use of some disease-modifying treatments.
To quantify changes in population-level infection rates among pwMS and compare these to the general population and people with rheumatoid arthritis (pwRA), and identify patient characteristics predictive of infections after MS diagnosis.
We conducted a multi-database study using data on 23,226 people with MS diagnosis from the UK Clinical Practice Research Datalink Aurum and GOLD (January 2000-December 2020). PwMS were matched to MS-free controls and pwRA. We calculated infection rates, and estimated incidence rate ratios (IRR) and 95% confidence intervals (CI) of predictors for infections ⩽ 5 years after MS diagnosis using Poisson regression.
Among pwMS, overall infection rates remained stable - 1.51-fold (1.49-1.52) that in MS-free controls and 0.87-fold (0.86-0.88) that in pwRA - although urinary tract infection rate per 1000 person-years increased from 98.7 (96.1-101) (2000-2010) to 136 (134-138) (2011-2020). Recent infection before MS diagnosis was most predictive of infections (1 infection: IRR 1.92 (1.86-1.97); ⩾2 infections: IRR 3.00 (2.89-3.10)).
The population-level elevated risk of infection among pwMS has remained stable despite the introduction of disease-modifying treatments.
多发性硬化症（pwMS）患者感染风险增加；风险因素包括基础疾病、身体损伤和使用某些疾病修正治疗。
量化 pwMS 人群中感染率的变化，并将其与普通人群和类风湿关节炎（pwRA）患者进行比较，并确定 MS 诊断后感染的患者特征。
我们使用来自英国临床实践研究数据链接 Aurum 和 GOLD 的 23226 名 MS 诊断患者的数据进行了一项多数据库研究（2000 年 1 月至 2020 年 12 月）。将 pwMS 与无 MS 对照组和 pwRA 进行匹配。我们使用泊松回归计算感染率，并估计 MS 诊断后 ⩽5 年内感染的预测因子的发病率比（IRR）和 95%置信区间（CI）。
在 pwMS 中，总体感染率保持稳定 - 是无 MS 对照组的 1.51 倍（1.49-1.52），是 pwRA 的 0.87 倍（0.86-0.88）- 尽管每 1000 人年的尿路感染率从 98.7（96.1-101）（2000-2010）增加到 136（134-138）（2011-2020）。MS 诊断前的近期感染是感染的最主要预测因素（1 次感染：IRR 1.92（1.86-1.97）； ⩾2 次感染：IRR 3.00（2.89-3.10））。
尽管引入了疾病修正治疗，但 pwMS 人群中感染的高风险仍保持稳定。
