The following is a summary of “Latent tuberculosis prevalence, diagnosis and treatment in Multiple Sclerosis as a strategy for reducing infection reactivation during immunosuppressant therapy,” published in the April 2024 issue of Neurology by Reis et al.

To prevent active tuberculosis in patients with Multiple Sclerosis (MS) on immunosuppressants, identifying and treating Latent Tuberculosis Infection (LTBI) is crucial.

Researchers conducted a retrospective study to assess the diagnosis and treatment of LTBI in patients with MS.

They conducted a cross-sectional study (February 2021 to June 2023) on LTBI prevalence and treatment in MS. The LTBI was characterized by asymptomatic presentation, positive PPD or IGRA, and clear chest X-ray findings.

The results showed 58 patients with MS, 17 (29.3 %) had LTBI, 15 with PPD > 5 mm, and 2 with positive IGRA. Among them, 10 (58.8 %) were female and 7 (41.1 %) were male, with a mean age of 41.3 (SD ±13.4) years. All patients with LTBI received immunomodulators or immunosuppressants: Fingolimod 5 (29.4 %), Natalizumab 5 (29.4 %), Cladribine 2 (11.8 %), Glatiramer 2 (11.8 %), Ocrelizumab 2 (11.8 %), and Interferon beta 1 (5.9 %). Steroid therapy for relapses was used in 93.8 % with LTBI and 81.1 % without. Isoniazid was prescribed to 64.7 % for LTBI treatment, and 35.3 % received Isoniazid plus Rifapentine. Hepatotoxicity occurred in 17.6 % with INH. ILTB treatment continued uninterrupted throughout the study.

Investigators concluded that a high number of patients had LTBI and treatment for it was well-tolerated.

Source: msard-journal.com/article/S2211-0348(24)00209-8/abstract