Balshi Alexandra, Dempsey John, Manning Nova, Leuenberger Grace, Baber Ursela, Sloane Jacob A
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
J Neurol. 2025 Feb 22;272(3):223. doi: 10.1007/s00415-025-12980-x.
People with multiple sclerosis (PwMS) may be at an increased risk of surgical site infections (SSIs). However, the role of specific MS disease-modifying therapies (DMTs) in modulating this risk remains underexplored.
The FDA Adverse Event Reporting System (FAERS) was used to investigate if MS DMTs are associated with disproportionally higher SSI reporting compared to other FAERS medications for individuals of all ages and those over the age of 50.
We identified 769 reports of SSIs across MS DMTs (352 in PwMS aged 50 or older) and 21 SSI-associated deaths. A pooled analysis of all DMTs revealed increased risks of SSIs (reporting odds ratio [ROR] of 1.95, 95% confidence interval [CI] 1.80-2.12) for all age groups and for those 50 or older (ROR of 2.58, 95% CI 2.27-2.92). For both age groups, ocrelizumab and interferon beta-1a met Evan's threshold for disproportionally high SSI reporting compared to all other FAERS medications.
MS DMTs are collectively associated with disproportionately high SSI reporting, especially for PwMS over the age of 50, with ocrelizumab and interferon beta-1a increasing SSI reporting risk in both age groups. These findings reveal a need to take extra precautions when caring for PwMS in a surgical setting, such as engaging wound care teams to minimize SSI risk.
多发性硬化症患者（PwMS）可能有更高的手术部位感染（SSIs）风险。然而，特定的多发性硬化症疾病修正疗法（DMTs）在调节此风险中的作用仍未得到充分研究。
使用美国食品药品监督管理局不良事件报告系统（FAERS）来调查与其他FAERS药物相比，MS DMTs在各年龄段及50岁以上个体中是否与过高的SSIs报告相关。
我们在MS DMTs中识别出769例SSIs报告（50岁及以上PwMS中有352例）以及21例与SSIs相关的死亡。对所有DMTs的汇总分析显示，所有年龄组以及50岁及以上人群的SSIs风险均增加（报告比值比[ROR]为1.95，95%置信区间[CI]为1.80 - 2.12）。对于这两个年龄组，与所有其他FAERS药物相比，奥瑞珠单抗和干扰素β-1a达到了Evan关于SSIs报告过高的阈值。
MS DMTs总体上与过高的SSIs报告相关，特别是对于50岁以上的PwMS，奥瑞珠单抗和干扰素β-1a在两个年龄组中均增加了SSIs报告风险。这些发现表明，在手术环境中护理PwMS时需要采取额外的预防措施，例如让伤口护理团队参与以尽量降低SSIs风险。
