Evaluation of Documented Infections by Provider Specialty in Patients with Multiple Sclerosis Receiving Disease-Modifying Therapies: A Claims Database Analysis.

introductionPeople with multiple sclerosis (pwMS) have an increased risk of infections. There are limited data characterizing who initially diagnoses infections in pwMS and how these are communicated among healthcare providers.

methodsRetrospective US claims data from January 1, 2017 to August 31, 2024 were used to identify newly diagnosed pwMS aged 18-64 years who were taking any disease-modifying therapy (DMT) for ≥ 90 days. Index date was the earliest date of the first DMT claim. Infections were based on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Severe infections included events requiring hospitalization and/or intravenous antibiotics.

resultsOverall, 69,148 pwMS who were treatment-naïve met eligibility criteria. Mean age was 44.1 years; 72% were female; and 81% were < 1 year from initial MS diagnosis to DMT initiation. A total of 316,497 infection events were reported over the study period, with 98% first reported by non-neurology providers. There were 21,416 severe infection events reported, of which > 98% were first reported by non-neurologists. In pwMS with infection events first reported by non-neurologists, 6% had a neurology visit ≤ 7 days after initial infection; of those, 8% had any infection ICD-10-CM code recorded at that visit (increased to 19% for serious infections). In the 16% of pwMS with a neurology visit ≤ 30 days post initial infection reported by a non-neurologist, 6% had any infection ICD-10-CM code recorded at that neurology visit (increased to 14% for severe infections).

conclusionMost infections in pwMS are first reported by non-neurology providers, as most pwMS did not interact with their MS clinician in the first few months after infection, even if that infection was severe. These data highlight the importance of communication between different providers and patients to accurately assess patient status and DMT safety, leading to improved patient outcomes.