Evidence map›Paper›PMID 32070858›Full record

ArticleMultiple sclerosis and related disorders2020

Infections in patients diagnosed with multiple sclerosis: A multi-database study.

R Persson, S Lee, M Ulcickas Yood, Capt M Wagner Usn Mc, N Minton, S Niemcryk, A Lindholm, A M Evans, S S Jick

Abstract read
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In one paragraph

Article in Multiple sclerosis and related disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 5 pooled it
9.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 5 syntheses or guidelines pooled it, 85 citations in OpenAlex.

  1. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Multiple sclerosis relapse after COVID-19 vaccination: A case report-based systematic review.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2022
    Pooled it
  3. Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2021
    Pooled it
  4. Guideline
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

R PerssonBoston Collaborative Drug Surveillance Program, Lexington, MA, USA.
S LeeBristol-Myers Squibb, Summit, NJ, USA.
M Ulcickas YoodEpiSource, LLC, Newton, MA, USA; Boston University School of Public Health, Boston, MA, USA.
Capt M Wagner Usn McDepartment of Neurology, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
N MintonBristol-Myers Squibb, Summit, NJ, USA.
S NiemcrykBristol-Myers Squibb, Summit, NJ, USA.
A LindholmBristol-Myers Squibb, Summit, NJ, USA.
A M EvansHealth ResearchTx, LLC, Trevose, PA, USA.
S S JickBoston Collaborative Drug Surveillance Program, Lexington, MA, USA; Boston University School of Public Health, Boston, MA, USA. Electronic address: sjick@bu.edu.
Bristol-Myers Squibb (United States) · USBoston University · USBoston Collaborative Drug Surveillance Program · USNaval Medical Center Portsmouth · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent data on the rates of infections among patients with multiple sclerosis (MS) are sparse. The objective of this study was to quantify incidence of infections in patients with MS compared with a matched sample of patients without MS (non-MS).

methodsThis study was conducted in two separate electronic medical databases: the United States Department of Defense (US-DOD) military health care system and the United Kingdom's Clinical Practice Research Datalink GOLD (UK-CPRD). We identified patients with a first recorded diagnosis of MS between 2001 and 2016 (UK-CPRD) or 2004 and 2017 (US-DOD) and matched non-MS patients. We identified infections recorded after the MS diagnosis date (or the matched date in non-MS patients) and calculated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) by infection site and type.

resultsRelative to non-MS patients, MS patients had higher rates of any infection (US-DOD IRR 1.76; 95% CI 1.72-1.80 and UK-CPRD IRR 1.25; 95% CI 1.21-1.29) and a two-fold higher rate of hospitalized infections (US-DOD IRR 2.43; 95% CI 2.23-2.63 and UK-CPRD IRR 2.00; 95% CI 1.84-2.17). IRs of any infection were higher in females compared with males in both MS and non-MS patients, while IRs of hospitalized infections were similar between sexes in both MS and non-MS patients. The IR of first urinary tract or kidney infection was nearly two-fold higher in MS compared with non-MS patients (US-DOD IRR 1.88; 95% CI 1.81-1.95 and UK-CPRD IRR 1.97; 95% CI 1.86-2.09) with higher rates in females compared with males. IRs for any opportunistic infection, candidiasis and any herpes virus were increased between 20 and 52% among MS patients compared with non-MS patients. IRs of meningitis, tuberculosis, hepatitis B and C were all low.

conclusionMS patients have an increased risk of infection, notably infections of the renal tract, and a two-fold increased risk of hospitalized infections compared with non-MS patients.

Indexed as

AdultAgedComorbidityDatabases, FactualElectronic Health RecordsFemaleHospitalizationHumansInfectionsMaleMiddle AgedMultiple SclerosisOpportunistic InfectionsSex FactorsUnited KingdomUnited StatesEpidemiologyInfectionsMultiple sclerosisOpportunistic infections

Identifiers

PMID32070858
OpenAlexW3004739468

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.