Meta-analysis of the incidence of malignancies and serious infections in patients with multiple sclerosis

The incidence of malignacies and serious infections is crucial for identifying risks associated with treatment and the presence of comorbidities in patients with multiple sclerosis (MS). Previously published outcomes are highly variable, and the aim of this study is therefore to clarify the incidence and identify risk factors related to the type of therapy and the presence of multiple comorbidities, and to compare them with data from the general population. The results of the meta-analysis clearly demonstrated a higher incidence of serious infections in MS patients compared to the general population. Approximately a threefold increase was observed in urinary tract infections, respiratory tract infections, and sepsis. Infectious complications were more frequent in patients treated with S1P modulators and anti-CD20 therapy. The incidence of malignancies was higher in MS patients compared to the general population, but only in one of the models. A higher incidence was then found for skin cancers (both non-melanoma and overall) and cancers of the female reproductive tract (although again, only in one model). The analysis highlights the importance of monitoring comorbidities and assessing individual risk when choosing disease-modifying therapies. Long-term exposure to immunosuppressive treatment, therapy type and duration, and the presence of additional risk factors can significantly influence the occurrence of infections and malignancies. The findings underline the need for further research to analyse the influence of age, gender, duration and type of treatment and the interaction between risk factors.