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

Balshi A, Dempsey JP, Zhang-James Y, Bove R.

research-articleOpen access

AI summary — for doctors, generated from the abstract only

Women with MS taking disease-modifying therapy had higher rates of several gynecologic problems than matched women not on therapy, especially with more immunosuppressive drugs.

What was studied

Propensity-matched multicenter database cohort of 115,522 women with MS comparing any DMT versus none, and moderate/high versus low immunosuppressive DMTs.

Key findings

DMT use was linked to higher risk of HPV positivity (RR 1.52) and cervical dysplasia (RR 1.40).
Cervical cancer risk was also higher (RR 1.23), as were cervicitis, HSV positivity, vulvovaginitis and Bartholin cysts/abscesses.
More immunosuppressive DMTs were associated with greater risk than low-immunosuppression ones.

Clinical relevance

Neurologists and gynecologists caring for women with MS should treat cervical screening and gynecologic review as part of DMT monitoring.

Who should care

Neurology

Limitations

This is an observational database study, so residual confounding and detection differences (more screening in treated women) may influence the associations, and the abstract is truncated in the moderate/high-versus-low results.

Make sure women on MS DMTs, especially more immunosuppressive agents, are up to date with HPV vaccination and cervical screening and counsel them about these risks.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background/objectives

The 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.

Methods

We 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).

Results

After 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.

DOI

10.1177/13524585261475100

PMID

42590993

PMCID

PMC13672867

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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