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Review
. 2021 Jul;268(7):2379-2389.
doi: 10.1007/s00415-019-09690-6. Epub 2020 Feb 8.

Effects of disease-modifying therapy on peripheral leukocytes in patients with multiple sclerosis

F Schweitzer  1 , S Laurent  1 , G R Fink  1   2 , Michael H Barnett  3 , H P Hartung #  4 , C Warnke #  5
Affiliations
Review

Effects of disease-modifying therapy on peripheral leukocytes in patients with multiple sclerosis

F Schweitzer et al. J Neurol. 2021 Jul.

Abstract

Modern disease-modifying therapies (DMTs) in multiple sclerosis (MS) have variable modes of action and selectively suppress or modulate the immune system. In this review, we summarize the predicted and intended as well as unwanted adverse effects on leukocytes in peripheral blood as a result of treatment with DMTs for MS. We link changes in laboratory tests to the possible therapeutic risks that include secondary autoimmunity, infections, and impaired response to vaccinations. Profound knowledge of the intended effects on leukocyte counts, in particular lymphocytes, explained by the mode of action, and adverse effects which may require additional laboratory and clinical vigilance or even drug discontinuation, is needed when prescribing DMTs to treat patients with MS.

Keywords: Disease-modifying therapy (DMT); Lymphopenia; Multiple sclerosis (MS).

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Conflict of interest statement

FS and SL have nothing to disclose. GRF received honoraria for speaking engagements from Bayer, Medica Academy Messe Duesseldorf, and Novartis. MHB has received institutional support for research, speaking and/or participation in advisory boards for Biogen, Merck, Novartis, Roche, and Sanofi Genzyme. He is a consulting neurologist for RxMx/Medical Safety Systems and research director for the Sydney Neuroimaging Analysis Centre. HPH received consultancy fees and fees for serving on steering or data monitoring committees and advisory boards from Bayer Healthcare, Biogen, GeNeuro, Genzyme, MedDay, Merck, Novartis, Celgene Receptos, Roche, and TG Therapeutics. CW has received institutional support from Novartis, Biogen, Sanofi Genzyme, and Roche.

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