Safety profile of MS therapies
There are many drugs approved for the treatment of MS that lead to good disease control and high patient adherence and compliance. Unfortunately, however, these drugs are not free from serious adverse reactions which in some cases are fatal. This is because there is little data on safety on newer drugs such as ocrelizumab. Alemtuzumab was in fact withdrawn from the market in Italy following serious adverse reactions with CMV reactivation. The safety profile of INF and glatiramer, on the other hand, has been evaluated in numerous studies, the most frequent adverse reactions recorded being the symptoms of the flu-like syndrome and the injection site reaction. This is why it is considered the safest drug. Fingolimod leads to serious adverse rations and the most common are infections, such as the urinary tract and lower respiratory tract infections. Such reactions have been shown to be due to the reduction of lymphocytes in the blood. The use of teriflunomide and dimethyl fumarate shows that these drugs lead to a slight reduction in the white blood cell count that could expose the patient to infectious risk. The adverse events of ocrelizumab concern allergic reactions for infusion, including itching, rash, urticaria and hypoglobulinemia and lymphocytopenia associated with secondary infections. Based on the present literature, post-marketing pharmacovigilance data and product CPR, it is clear that there is an increased risk of infection associated with drugs for MS. The marked reduction in IgG and IgA leads to an increased risk of causing infection, so the drugs for MS that cause a high reduction in IgG lead to a marked risk of infection for the patient. Drugs such as Ocrelizumab Cladribina should definitely be avoided because of their marked lymphocytopenia (13-34).