The following is a summary of “Do immune checkpoint inhibitors affect the course of multiple sclerosis? A systematic review and meta-analysis,” published in the November 2024 issue of Neurology by Gelibter et al.    

Older people with multiple sclerosis (pwMS) have an increased risk of malignancies. Immune checkpoint inhibitors (ICIs) improve cancer outcomes but may trigger disease flares in individuals with pre-existing autoimmune diseases, such as MS.  

Researchers conducted a retrospective study evaluating the effects of ICIs on MS disease activity.  

They searched Google Scholar and PubMed, identifying 5 observational studies. The studies analyzed clinical and neuroradiological outcomes using random-effects models (pooled relapse rate per 100 patient-years = 5.45, 95% CI = 1.86–14.92; pooled new magnetic resonance imaging [MRI] lesion rate per 100 patient-years = 24.9, 95% CI = 10.9–47.3).  

The results showed a pooled relapse rate of 5.45 per 100 patient-years (95% CI = 1.86–14.92), with a median time to relapse being 1 month after starting ICIs therapy (range = 0.4–6 months), no relapse occurred in individuals older than 58 years. The pooled rate of new MRI lesions was 24.9 per 100 patient-years (95% CI = 10.9–47.3), with a median time to new lesions of 3 months (range = 1–6 months).  

They concluded that ICIs in pwMS were associated with a low relapse rate, though an increased risk of neuroradiological activity was observed, especially in patients who discontinued disease-modifying treatments.  

Source: onlinelibrary.wiley.com/doi/full/10.1111/ene.16547