Gynecologic complications of disease-modifying therapy in women with multiple sclerosis.

Alexandra Balshi, John P Dempsey, Yanli Zhang-James, Riley Bove

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Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Alexandra BalshiDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-3202-6921

John P DempseyNorton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

Yanli Zhang-JamesNorton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

Riley BoveUCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0002-2034-8800

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesThe long-term implications of multiple sclerosis (MS) disease-modifying therapies (DMTs) on gynecologic health remain understudied. We leverage a multicenter database to evaluate whether DMTs are associated with such complications.

methodsWe propensity-score 1:1 matched women with MS on (1) any versus no or (2) moderate- to high- (vs low-) immunosuppressive DMT by age, marital status, race, ethnicity, tobacco use, body mass index, human papilloma virus (HPV) vaccination, and gynecologic examinations/screenings. We then compared matched cohorts with risk ratios (RRs) and 95% confidence intervals (CIs).

resultsAfter matching, we analyzed 115,522 women with MS. The DMT (vs no DMT) group had increased risks of HPV positivity (RR: 1.52, 95% CI: 1.35-172), cervical dysplasia (RR: 1.40, 95% CI: 1.31-1.49), cervical cancer (RR: 1.23, 95% CI: 1.03-1.46), cervicitis (RR: 1.25, 95% CI: 1.10-1.41), herpes simplex virus positivity (RR: 1.29, 95% CI: 1.14-1.45), vulvovaginitis (RR: 1.30, 95% CI: 1.23-1.37), and Bartholin cysts/abscesses (RR: 1.37, 95% CI: 1.07-1.76). Moderate- to high- (vs low-) immunosuppressive. DISCUSSION: MS DMTs, especially more immunosuppressive ones, are associated with increased risks of several gynecologic complications. Clinicians should recognize these potential sequelae of DMTs and integrate gynecological counseling/screening into MS care.

Indexed as

Disease-modifying therapiesmultiple sclerosis

Identifiers

PMID42590993

DOI10.1177/13524585261475100

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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.