Key clinical point: Women presenting with multiple sclerosis (MS) are more likely to develop trigeminal neuralgia (TN) relative to men with MS.

Major finding: The estimated pooled TN prevalence in the overall population was 3.4%, with the prevalence being greater among women with MS (3.8%; 95% CI, 0.8%-8.7%) than among men with MS (2.4%; 95% CI, 0.5%-5.4%).

Study details: Findings are from a meta-analysis of 19 studies involving 30,348 patients with MS.

Disclosures: This study reported no funding source or conflict of interests.

Source: Houshi S et al. Mult Scler Relat Disord. 2021 Dec 28. doi: 10.1016/j.msard.2021.103472.

Key clinical point: Women presenting with multiple sclerosis (MS) are more likely to develop trigeminal neuralgia (TN) relative to men with MS.

Major finding: The estimated pooled TN prevalence in the overall population was 3.4%, with the prevalence being greater among women with MS (3.8%; 95% CI, 0.8%-8.7%) than among men with MS (2.4%; 95% CI, 0.5%-5.4%).

Study details: Findings are from a meta-analysis of 19 studies involving 30,348 patients with MS.

Disclosures: This study reported no funding source or conflict of interests.

Source: Houshi S et al. Mult Scler Relat Disord. 2021 Dec 28. doi: 10.1016/j.msard.2021.103472.

Key clinical point: Women presenting with multiple sclerosis (MS) are more likely to develop trigeminal neuralgia (TN) relative to men with MS.

Major finding: The estimated pooled TN prevalence in the overall population was 3.4%, with the prevalence being greater among women with MS (3.8%; 95% CI, 0.8%-8.7%) than among men with MS (2.4%; 95% CI, 0.5%-5.4%).

Study details: Findings are from a meta-analysis of 19 studies involving 30,348 patients with MS.

Disclosures: This study reported no funding source or conflict of interests.

Source: Houshi S et al. Mult Scler Relat Disord. 2021 Dec 28. doi: 10.1016/j.msard.2021.103472.

Key clinical point: Ocrelizumab may be preferred over fingolimod as an exit strategy after natalizumab discontinuation in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: At 1 year, fewer relapses were observed in patients receiving ocrelizumab vs fingolimod (0.12±0.39 vs 0.41±0.71; P = .035), realizing a 70.7% lower annualized relapse rate. The cumulative probability of relapse was significantly higher with fingolimod vs ocrelizumab (31.5% vs 10.4%; adjusted hazard ratio, 3.4; P = .04).

Study details: The data come from an observational, retrospective study involving 102 patients with RRMS who received either fingolimod (n=54) or ocrelizumab (n=48) after natalizumab cessation.

Disclosures: No source of funding was disclosed. Some of the authors including the lead author reported receiving consultancy fees and travel grants from various pharmaceutical companies.

Source: Bigaut K et al. J Neurol. 2022 Jan 4. doi: 10.1007/s00415-021-10950-7.

Key clinical point: Ocrelizumab may be preferred over fingolimod as an exit strategy after natalizumab discontinuation in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: At 1 year, fewer relapses were observed in patients receiving ocrelizumab vs fingolimod (0.12±0.39 vs 0.41±0.71; P = .035), realizing a 70.7% lower annualized relapse rate. The cumulative probability of relapse was significantly higher with fingolimod vs ocrelizumab (31.5% vs 10.4%; adjusted hazard ratio, 3.4; P = .04).

Study details: The data come from an observational, retrospective study involving 102 patients with RRMS who received either fingolimod (n=54) or ocrelizumab (n=48) after natalizumab cessation.

Disclosures: No source of funding was disclosed. Some of the authors including the lead author reported receiving consultancy fees and travel grants from various pharmaceutical companies.

Source: Bigaut K et al. J Neurol. 2022 Jan 4. doi: 10.1007/s00415-021-10950-7.

Key clinical point: Ocrelizumab may be preferred over fingolimod as an exit strategy after natalizumab discontinuation in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: At 1 year, fewer relapses were observed in patients receiving ocrelizumab vs fingolimod (0.12±0.39 vs 0.41±0.71; P = .035), realizing a 70.7% lower annualized relapse rate. The cumulative probability of relapse was significantly higher with fingolimod vs ocrelizumab (31.5% vs 10.4%; adjusted hazard ratio, 3.4; P = .04).

Study details: The data come from an observational, retrospective study involving 102 patients with RRMS who received either fingolimod (n=54) or ocrelizumab (n=48) after natalizumab cessation.

Disclosures: No source of funding was disclosed. Some of the authors including the lead author reported receiving consultancy fees and travel grants from various pharmaceutical companies.

Source: Bigaut K et al. J Neurol. 2022 Jan 4. doi: 10.1007/s00415-021-10950-7.

Key clinical point: Cognitive dysfunction in patients with multiple sclerosis (MS) is predictive of a higher risk for conversion from relapse-remitting MS to secondary progressive MS and a higher risk for death.

Major finding: Cognitive dysfunction was linked to a greater risk of converting from relapse-remitting course to progressive disease course (adjusted odds ratio, 2.29; P = .043) and shorter survival (adjusted hazard ratio, 3.07; P = .006).

Study details: This was a retrospective analysis of 408 patients with MS.

Disclosures: No external funding was received for this study. The authors reported no conflict of interests.

Source: Cavaco S et al. Mult Scler. 2021 Dec 30. doi: 10.1177/13524585211066598.

Key clinical point: Cognitive dysfunction in patients with multiple sclerosis (MS) is predictive of a higher risk for conversion from relapse-remitting MS to secondary progressive MS and a higher risk for death.

Major finding: Cognitive dysfunction was linked to a greater risk of converting from relapse-remitting course to progressive disease course (adjusted odds ratio, 2.29; P = .043) and shorter survival (adjusted hazard ratio, 3.07; P = .006).

Study details: This was a retrospective analysis of 408 patients with MS.

Disclosures: No external funding was received for this study. The authors reported no conflict of interests.

Source: Cavaco S et al. Mult Scler. 2021 Dec 30. doi: 10.1177/13524585211066598.

Key clinical point: Cognitive dysfunction in patients with multiple sclerosis (MS) is predictive of a higher risk for conversion from relapse-remitting MS to secondary progressive MS and a higher risk for death.

Major finding: Cognitive dysfunction was linked to a greater risk of converting from relapse-remitting course to progressive disease course (adjusted odds ratio, 2.29; P = .043) and shorter survival (adjusted hazard ratio, 3.07; P = .006).

Study details: This was a retrospective analysis of 408 patients with MS.

Disclosures: No external funding was received for this study. The authors reported no conflict of interests.

Source: Cavaco S et al. Mult Scler. 2021 Dec 30. doi: 10.1177/13524585211066598.

Key clinical point: Spending more time outdoors in the summer and higher exposure to summer ultraviolet radiation (UVR) markedly reduces the risk of developing pediatric multiple sclerosis (MS).

Major finding: Compared with spending <30 minutes outdoors daily during the most recent summer, greater time spent outdoors was associated with a significantly decreased risk of developing MS (30-60 minutes: adjusted odds ratio [aOR], 0.48; P = .05; 1-2 hours: aOR, 0.19; P < .001). Additionally, the ambient UVR dose also showed a protective effect (aOR, 0.76; P = .01).

Study details: This was a multicenter case-control study involving children with MS (n=332) compared with age- and gender-matched controls (n=534).

Disclosures: This study was funded by the NIH and the National MS Society. Some of the authors declared receiving grants from National MS Society and NIH and/or financial support and consulting/personal fees from various other sources.

Source: Sebastian P et al. Neurology. 2021 Dec 8. doi: 10.1212/WNL.0000000000013045.

Key clinical point: Spending more time outdoors in the summer and higher exposure to summer ultraviolet radiation (UVR) markedly reduces the risk of developing pediatric multiple sclerosis (MS).

Major finding: Compared with spending <30 minutes outdoors daily during the most recent summer, greater time spent outdoors was associated with a significantly decreased risk of developing MS (30-60 minutes: adjusted odds ratio [aOR], 0.48; P = .05; 1-2 hours: aOR, 0.19; P < .001). Additionally, the ambient UVR dose also showed a protective effect (aOR, 0.76; P = .01).

Study details: This was a multicenter case-control study involving children with MS (n=332) compared with age- and gender-matched controls (n=534).

Disclosures: This study was funded by the NIH and the National MS Society. Some of the authors declared receiving grants from National MS Society and NIH and/or financial support and consulting/personal fees from various other sources.

Source: Sebastian P et al. Neurology. 2021 Dec 8. doi: 10.1212/WNL.0000000000013045.

Key clinical point: Spending more time outdoors in the summer and higher exposure to summer ultraviolet radiation (UVR) markedly reduces the risk of developing pediatric multiple sclerosis (MS).

Major finding: Compared with spending <30 minutes outdoors daily during the most recent summer, greater time spent outdoors was associated with a significantly decreased risk of developing MS (30-60 minutes: adjusted odds ratio [aOR], 0.48; P = .05; 1-2 hours: aOR, 0.19; P < .001). Additionally, the ambient UVR dose also showed a protective effect (aOR, 0.76; P = .01).

Study details: This was a multicenter case-control study involving children with MS (n=332) compared with age- and gender-matched controls (n=534).

Disclosures: This study was funded by the NIH and the National MS Society. Some of the authors declared receiving grants from National MS Society and NIH and/or financial support and consulting/personal fees from various other sources.

Source: Sebastian P et al. Neurology. 2021 Dec 8. doi: 10.1212/WNL.0000000000013045.

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk for cancer than the general population.

Major finding: Compared with the general population, patients with MS were at a significantly higher risk for cancer (hazard ratio [HR], 1.36; 95% CI, 1.29-1.43), particularly prostate cancer (HR, 2.08; 95% CI, 1.68-2.58), colorectal and anal cancer (HR, 1.35; 95% CI, 1.16-1.58), and trachea bronchus and lung cancer (HR, 2.36; 95% CI, 1.96-2.84).

Study details: This population-based matched-cohort study included 95,474 patients with MS matched with 95,474 individuals from the general population.

Disclosures: This study was sponsored by Merck Healthcare KGaA. Four authors including the lead author reported being employees of the Bordeaux PharmacoEpi, and the remaining authors reported being full-time employees of Merck Healthcare KGaA, Darmstadt, Germany. The lead author reported receiving speaker fees from Biogen.

Source: Bosco-Lévy P et al. Eur J Neurol. 2021 Dec 22. doi: 10.1111/ene.15226.

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk for cancer than the general population.

Major finding: Compared with the general population, patients with MS were at a significantly higher risk for cancer (hazard ratio [HR], 1.36; 95% CI, 1.29-1.43), particularly prostate cancer (HR, 2.08; 95% CI, 1.68-2.58), colorectal and anal cancer (HR, 1.35; 95% CI, 1.16-1.58), and trachea bronchus and lung cancer (HR, 2.36; 95% CI, 1.96-2.84).

Study details: This population-based matched-cohort study included 95,474 patients with MS matched with 95,474 individuals from the general population.

Disclosures: This study was sponsored by Merck Healthcare KGaA. Four authors including the lead author reported being employees of the Bordeaux PharmacoEpi, and the remaining authors reported being full-time employees of Merck Healthcare KGaA, Darmstadt, Germany. The lead author reported receiving speaker fees from Biogen.

Source: Bosco-Lévy P et al. Eur J Neurol. 2021 Dec 22. doi: 10.1111/ene.15226.

Key clinical point: Patients with multiple sclerosis (MS) are at an increased risk for cancer than the general population.

Major finding: Compared with the general population, patients with MS were at a significantly higher risk for cancer (hazard ratio [HR], 1.36; 95% CI, 1.29-1.43), particularly prostate cancer (HR, 2.08; 95% CI, 1.68-2.58), colorectal and anal cancer (HR, 1.35; 95% CI, 1.16-1.58), and trachea bronchus and lung cancer (HR, 2.36; 95% CI, 1.96-2.84).

Study details: This population-based matched-cohort study included 95,474 patients with MS matched with 95,474 individuals from the general population.

Disclosures: This study was sponsored by Merck Healthcare KGaA. Four authors including the lead author reported being employees of the Bordeaux PharmacoEpi, and the remaining authors reported being full-time employees of Merck Healthcare KGaA, Darmstadt, Germany. The lead author reported receiving speaker fees from Biogen.

Source: Bosco-Lévy P et al. Eur J Neurol. 2021 Dec 22. doi: 10.1111/ene.15226.

Key clinical point: Cognitive impairments may be evaluated up to 30 days before and up to 550 days after a relapse, beyond which they revert to prerelapse levels in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: From 30 days prerelapse to 550 days postrelapse, there was a significant drop in the Symbol Digit Modalities Test (SDMT) score, with the largest decline occurring at 0-30 days postrelapse (β-coefficient, −4.00; 95% CI, −4.61 to −3.39) compared with the period of remission.

Study details: This nationwide cohort study recorded 31,529 SDMTs from among 3,877 patients with incident RRMS, each having a minimum of 2 SDMT scores recorded.

Disclosures: This study was funded by a postdoctoral fellowship award to KA McKay from the Swedish Research Council for Health, Working Life, and Welfare (Forte). The authors reported no conflict of interests.

Source: McKay KA et al. Ann Neurol. 2022 Jan 4. doi: 10.1002/ana.26301.

Key clinical point: Cognitive impairments may be evaluated up to 30 days before and up to 550 days after a relapse, beyond which they revert to prerelapse levels in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: From 30 days prerelapse to 550 days postrelapse, there was a significant drop in the Symbol Digit Modalities Test (SDMT) score, with the largest decline occurring at 0-30 days postrelapse (β-coefficient, −4.00; 95% CI, −4.61 to −3.39) compared with the period of remission.

Study details: This nationwide cohort study recorded 31,529 SDMTs from among 3,877 patients with incident RRMS, each having a minimum of 2 SDMT scores recorded.

Disclosures: This study was funded by a postdoctoral fellowship award to KA McKay from the Swedish Research Council for Health, Working Life, and Welfare (Forte). The authors reported no conflict of interests.

Source: McKay KA et al. Ann Neurol. 2022 Jan 4. doi: 10.1002/ana.26301.

Key clinical point: Cognitive impairments may be evaluated up to 30 days before and up to 550 days after a relapse, beyond which they revert to prerelapse levels in patients with relapsing-remitting multiple sclerosis (RRMS).

Major finding: From 30 days prerelapse to 550 days postrelapse, there was a significant drop in the Symbol Digit Modalities Test (SDMT) score, with the largest decline occurring at 0-30 days postrelapse (β-coefficient, −4.00; 95% CI, −4.61 to −3.39) compared with the period of remission.

Study details: This nationwide cohort study recorded 31,529 SDMTs from among 3,877 patients with incident RRMS, each having a minimum of 2 SDMT scores recorded.

Disclosures: This study was funded by a postdoctoral fellowship award to KA McKay from the Swedish Research Council for Health, Working Life, and Welfare (Forte). The authors reported no conflict of interests.

Source: McKay KA et al. Ann Neurol. 2022 Jan 4. doi: 10.1002/ana.26301.

Key clinical point: Treatment with interferon (IFN)-beta 1A improved the SARS-CoV-2-mRNA vaccine-specific humoral response in patients with multiple sclerosis (MS), which was significantly reduced in patients treated with cladribine, fingolimod, or ocrelizumab.

Major finding: Antispike immunoglobulin (Ig)G levels were significantly higher in IFN-treated patients with MS vs healthy controls (median, 1,916 vs 1,089; P = .029); however, antispike IgG levels were significantly lower in patients treated with cladribine (P = .002), fingolimod (P < .0001), or ocrelizumab (P < .0001).

Study details: This was a prospective monocentric study involving 149 patients with MS treated with disease-modifying therapies who were age- and gender-matched to 26 healthy controls, all of whom had no history of SARS-CoV-2 infection and received 2 doses of BNT162b2-mRNA COVID-19 vaccine.

Disclosures: This study was supported by Fondazione Italiana Sclerosi Multipla and others. The authors declared no conflict of interests.

Source: Maniscalco GT et al. Mult Scler Relat Disord. 2021 Dec 18. doi: 10.1016/j.msard.2021.103455.

Key clinical point: Treatment with interferon (IFN)-beta 1A improved the SARS-CoV-2-mRNA vaccine-specific humoral response in patients with multiple sclerosis (MS), which was significantly reduced in patients treated with cladribine, fingolimod, or ocrelizumab.

Major finding: Antispike immunoglobulin (Ig)G levels were significantly higher in IFN-treated patients with MS vs healthy controls (median, 1,916 vs 1,089; P = .029); however, antispike IgG levels were significantly lower in patients treated with cladribine (P = .002), fingolimod (P < .0001), or ocrelizumab (P < .0001).

Study details: This was a prospective monocentric study involving 149 patients with MS treated with disease-modifying therapies who were age- and gender-matched to 26 healthy controls, all of whom had no history of SARS-CoV-2 infection and received 2 doses of BNT162b2-mRNA COVID-19 vaccine.

Disclosures: This study was supported by Fondazione Italiana Sclerosi Multipla and others. The authors declared no conflict of interests.

Source: Maniscalco GT et al. Mult Scler Relat Disord. 2021 Dec 18. doi: 10.1016/j.msard.2021.103455.

Key clinical point: Treatment with interferon (IFN)-beta 1A improved the SARS-CoV-2-mRNA vaccine-specific humoral response in patients with multiple sclerosis (MS), which was significantly reduced in patients treated with cladribine, fingolimod, or ocrelizumab.

Major finding: Antispike immunoglobulin (Ig)G levels were significantly higher in IFN-treated patients with MS vs healthy controls (median, 1,916 vs 1,089; P = .029); however, antispike IgG levels were significantly lower in patients treated with cladribine (P = .002), fingolimod (P < .0001), or ocrelizumab (P < .0001).

Study details: This was a prospective monocentric study involving 149 patients with MS treated with disease-modifying therapies who were age- and gender-matched to 26 healthy controls, all of whom had no history of SARS-CoV-2 infection and received 2 doses of BNT162b2-mRNA COVID-19 vaccine.

Disclosures: This study was supported by Fondazione Italiana Sclerosi Multipla and others. The authors declared no conflict of interests.

Source: Maniscalco GT et al. Mult Scler Relat Disord. 2021 Dec 18. doi: 10.1016/j.msard.2021.103455.

Key clinical point: Discontinuation of natalizumab seemed safe in patients with multiple sclerosis (MS), who converted to secondary MS during treatment, with a high annual relapse rate (ARR) before natalizumab treatment being a risk factor for early relapse posttreatment discontinuation.

Major finding: After natalizumab discontinuation, conversion to secondary MS during treatment was protective for disease reactivation (odds ratio [OR], 0.08; P = .03), whereas ARR before treatment was the only risk factor for early relapse (OR, 1.46; P = .014).

Study details: This was a retrospective analysis of 235 patients with MS who were treated with natalizumab, of whom 105 discontinued the treatment.

Disclosures: No information on funding was provided. E Fava reported no conflict of interests, and the other authors reported receiving fees for acting as an advisor/speaker/consultant or receiving grants for travel/research from various sources.

Source: Auer M et al. Sci Rep. 2021 Dec 2. doi: 10.1038/s41598-021-02665-6.

Key clinical point: Discontinuation of natalizumab seemed safe in patients with multiple sclerosis (MS), who converted to secondary MS during treatment, with a high annual relapse rate (ARR) before natalizumab treatment being a risk factor for early relapse posttreatment discontinuation.

Major finding: After natalizumab discontinuation, conversion to secondary MS during treatment was protective for disease reactivation (odds ratio [OR], 0.08; P = .03), whereas ARR before treatment was the only risk factor for early relapse (OR, 1.46; P = .014).

Study details: This was a retrospective analysis of 235 patients with MS who were treated with natalizumab, of whom 105 discontinued the treatment.

Disclosures: No information on funding was provided. E Fava reported no conflict of interests, and the other authors reported receiving fees for acting as an advisor/speaker/consultant or receiving grants for travel/research from various sources.

Source: Auer M et al. Sci Rep. 2021 Dec 2. doi: 10.1038/s41598-021-02665-6.

Key clinical point: Discontinuation of natalizumab seemed safe in patients with multiple sclerosis (MS), who converted to secondary MS during treatment, with a high annual relapse rate (ARR) before natalizumab treatment being a risk factor for early relapse posttreatment discontinuation.

Major finding: After natalizumab discontinuation, conversion to secondary MS during treatment was protective for disease reactivation (odds ratio [OR], 0.08; P = .03), whereas ARR before treatment was the only risk factor for early relapse (OR, 1.46; P = .014).

Study details: This was a retrospective analysis of 235 patients with MS who were treated with natalizumab, of whom 105 discontinued the treatment.

Disclosures: No information on funding was provided. E Fava reported no conflict of interests, and the other authors reported receiving fees for acting as an advisor/speaker/consultant or receiving grants for travel/research from various sources.

Source: Auer M et al. Sci Rep. 2021 Dec 2. doi: 10.1038/s41598-021-02665-6.

Key clinical point: COVID-19 vaccines are safe and elicit a protective humoral response in most patients with multiple sclerosis (MS) who were treated with disease-modifying treatments (DMTs) or remained untreated, except for some patients treated with fingolimod or ocrelizumab.

Major finding: Overall, 86.8% of patients developed a positive humoral response against SARS-CoV-2, with only some patients treated with fingolimod (22.2%) or ocrelizumab (66%) failing to produce a significant humoral response (P < .01). Moreover, immunoglobulin G levels against SARS-CoV2 were significantly lower in patients treated with fingolimod or ocrelizumab than those treated with other DMTs or those who remained untreated (P < .01). None of the patients experienced any adverse events requiring hospitalization.

Study details: This was a prospective cohort study involving 140 patients with MS who were treated with different DMTs and had received vaccination for COVID-19 (mostly BNT162b2).

Disclosures: No source of funding was declared.

Source: Capone F et al. Neurotherapeutics. 2021 Dec 3. doi: 10.1007/s13311-021-01165-9.

Key clinical point: COVID-19 vaccines are safe and elicit a protective humoral response in most patients with multiple sclerosis (MS) who were treated with disease-modifying treatments (DMTs) or remained untreated, except for some patients treated with fingolimod or ocrelizumab.

Major finding: Overall, 86.8% of patients developed a positive humoral response against SARS-CoV-2, with only some patients treated with fingolimod (22.2%) or ocrelizumab (66%) failing to produce a significant humoral response (P < .01). Moreover, immunoglobulin G levels against SARS-CoV2 were significantly lower in patients treated with fingolimod or ocrelizumab than those treated with other DMTs or those who remained untreated (P < .01). None of the patients experienced any adverse events requiring hospitalization.

Study details: This was a prospective cohort study involving 140 patients with MS who were treated with different DMTs and had received vaccination for COVID-19 (mostly BNT162b2).

Disclosures: No source of funding was declared.

Source: Capone F et al. Neurotherapeutics. 2021 Dec 3. doi: 10.1007/s13311-021-01165-9.

Key clinical point: COVID-19 vaccines are safe and elicit a protective humoral response in most patients with multiple sclerosis (MS) who were treated with disease-modifying treatments (DMTs) or remained untreated, except for some patients treated with fingolimod or ocrelizumab.

Major finding: Overall, 86.8% of patients developed a positive humoral response against SARS-CoV-2, with only some patients treated with fingolimod (22.2%) or ocrelizumab (66%) failing to produce a significant humoral response (P < .01). Moreover, immunoglobulin G levels against SARS-CoV2 were significantly lower in patients treated with fingolimod or ocrelizumab than those treated with other DMTs or those who remained untreated (P < .01). None of the patients experienced any adverse events requiring hospitalization.

Study details: This was a prospective cohort study involving 140 patients with MS who were treated with different DMTs and had received vaccination for COVID-19 (mostly BNT162b2).

Disclosures: No source of funding was declared.

Source: Capone F et al. Neurotherapeutics. 2021 Dec 3. doi: 10.1007/s13311-021-01165-9.