Results from an Italian Consensus Conference on prevention and management of infections in multiple sclerosis patients treated with biological and non biological disease modifying drugs
Author(s): ,
L. Moiola
Affiliations:
Neurology, Vita-Salute San Raffaele University
,
V. Barcella
Affiliations:
Neurology, Neurology DIvision, USS Malattie Autoimmuni, ASST Papa Giovanni XXIII
,
S. Benatti
Affiliations:
Infectious Disease Department, Division of Infectious Diseases, ASST Papa Giovanni XXIII, Bergamo
,
L. Prosperini
Affiliations:
Department of Neurosciences, Department of Neurosciences, Ospedale San Camillo, Roma
,
F. Franzetti
Affiliations:
Infectious Disease Department, III Division of Infectious Diseases, ASST FBF-Sacco, University of Milan, Milan, Milan
,
M. Zaffaroni
Affiliations:
Neurology, Centro Sclerosi Multipla, Ospedale di Gallarate, ASST Valle Olona, Gallarate
,
M. Puoti
Affiliations:
Infectious Disease Department, Niguarda Hepatitis Center, Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Milan
,
C. Tortorella
Affiliations:
Neurology, Department of Neurosciences, Ospedale San Camillo, Roma
,
M. Fasolo
Affiliations:
Infectious Disease Department, Division of Infectious Diseases, ASST FBF-Sacco, University of Milan
,
M. Origoni
Affiliations:
Gynecology Department, Vita-Salute San Raffaele University, Milan
,
R. Capra
Affiliations:
Multiple Sclerosis Center, Multiple Sclerosis Center, ASST Spedali Civili, Brescia
,
C. Scarpazza
Affiliations:
Multiple Sclerosis Center, Multiple Sclerosis Center, ASST Spedali Civili, Brescia
,
P. Cinque
Affiliations:
Infectious Disease Department, Department of Infectious Diseases, IRCCS-San Raffaele Hospital
,
S. Gerevini
Affiliations:
Neuroradiology Department, IRCCS San Raffaele Hospital, Milan
,
M. Capobianco
Affiliations:
Multiple Sclerosis Center, SCDO Neurologia, Centro di Riferimento Regionale Sclerosi Multipla, AOU San Luigi Gonzaga, Torino
,
L. Meroni
Affiliations:
Infectious Disease Department, III Division of Infectious Diseases, ASST FBF-Sacco, University of Milan, Milan, Milan
,
M. Galli
Affiliations:
Infectious Disease Department, III Division of Infectious Diseases, ASST FBF-Sacco, University of Milan, Milan, Milan
,
G. Comi
Affiliations:
Neurology, Vita-Salute San Raffaele University
,
A. Riva
Affiliations:
Infectious Disease Department, III Division of Infectious Diseases, ASST FBF-Sacco, University of Milan, Milan 5, Milan, Italy
Infectious Consensus on MS
Infectious Consensus on MS
Affiliations:
ECTRIMS Online Library. Moiola L. Oct 12, 2018; 229089; P1249
Lucia Moiola
Lucia Moiola
Contributions
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Abstract

Abstract: P1249

Type: Poster Sessions

Abstract Category: Therapy - Risk management for disease modifying treatments

Introduction: Multiple sclerosis (MS) patients have a higher risk of infections than healthy controls. Disease modifying drugs (DMDs) can increase that risk, therefore, recommendation guidelines for neurologists and infectious specialists are strongly needed in order to prevent and manage infections.
Aims: to verify the incidence of different infectious diseases (ID) in MS patients according to the therapeutic agents and define management recommendations.
Methods: The “modified Delphi method” including three main phases was adopted: 1 constitution of an experts panel (7 neurologists and 7 ID specialists, 1 neuroradiologist and 1 gynecologist) and identification of 6 main topics: vaccines, urinary and HPV infections, respiratory infections including influenza and tuberculosis, viral hepatitis, opportunistic infections, and progressive multifocal encephalopathy. The second “analytic-phase” consisted of a systematic literature search, with revision and selection of papers in order to answer the clinical questions and to formulate statements. A conference composed of a larger panel (27 neurologists and 27 ID specialists) discussed the proposed statements: a first Delphi round-1 “hot vote” using a unipolar Liker scale and, one month later, an online “cold vote” for those statements not validated in the first one (Delphi round-2). In the third “evaluation-phase”: grading and meta-analysis of all scientific data were determined with final drafting of recommendations.
Results:
the consensus panel drew recommendations guidelines for the six topics collecting the results in two categories: the first regarding vaccines, proposing a vaccination card at the time of MS diagnosis; the second, regarding ID screening before DMD initiation in order to treat latent/active infections, ID monitoring and treatment focusing on the time period needed to wait to start/restart or discontinue a DMD.
Conclusions:
in the complex MS “era treatment” collaboration between different specialists is mandatory in order to avoid and/or manage adverse events related to DMD with particular focus on infections. We present the recommendation guidelines for six topics to help neurologists and ID specialists.
Disclosure: L. Moiola:speaking honoraria and/or consultant fees from Biogen Idec, Merck Serono, Sanofi- Genzyme, Novartis and TEVA
V.Barcella:speaking honoraria and/or consultant fees from Biogen Idec, Merck Serono, Bayer, Sanofi- Genzyme, Novartis.
S. Benatti: nothing to disclose
L. Prosperini: has received consulting fees from Biogen, Genzyme, Novartis and Roche; speaker honoraria from Almirall, Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme
F. Franzetti: Speaker honorarium per Merck Sharp & Dohme, Angelini e Nordic Pharma.
M. Zaffaroni: has received honoraria for consultancy, lecturing or participating in advisory boards, and travel expenses for attending scientific meetings paid by Almirall, Biogen, Genzyme, Merck, Novartis, Teva.
M. Puoti: Speaker in own events and/or in internal courses and/or member of temporary advisory boards for Abbvie, Gilead sciences, MSD, Beckman Coulter
C. Tortorella: has served on advisory boards and/or has received travel grants and/or speaker honoraria from Merck Serono, Roche, Teva Italia, Biogen, Almirall, Novartis, Sanofi-Genzyme
M. Fasolo: nothing to disclose
M. Origoni, nothing to disclose
R. Capra: has received lecture fees and/or travel grants from Novartis, Biogen, Celgene, Novartis, TEVA, Genzyme and Sanofi-Aventis:
C. Scarpazza: nothing to disclose
P. Cinque: speaking honoraria and/or consultant fees from Biogen, Bristol-Myers Squib, Gilead Science, Inhibikase Ther., Janssen Cilag, Johnson & Johnson, Merck, Millenium Pharmaceuticals, Novartis, Pfizer, Shire, Viiv Healthcare
S.Gerevini: nothing to disclose
M. Capobianco: has received personal compensation for speaking honoraria or partecipating in advisory board from Almirall, Biogen, Merck, Novartis, Roche, Sanofy, Teva
L. Meroni: nothing to disclose
M. Galli: Abbvie, Angelini, BMD, Gilead Sciences, GSK, Janssen-Cilag, MSD, Pfizer, ViiV
G. Comi1, has received compensation for consulting services and /or for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Celgene, Forward Pharma, Medday.
A. Riva: has received speaker's honorarium from viiv, BMS, Gilead, merck, sanofi, Novartis

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