Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications

• Published in: European journal of medical research Vol. 29; no. 1; pp. 344 - 13
• Main Authors: Ou Yong, Brian M, Awuah, Wireko Andrew, Shah, Muhammad Hamza, Sanker, Vivek, Huk, Jonathan Kong Sing, Venkata, Sujashree Yadala, Patel, Diti H, Tan, Joecelyn Kirani, Khan, Noor Ayman, Kulasekaran, Ajitha, Sarkar, Manali, Abdul-Rahman, Toufik, Atallah, Oday
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25.06.2024; BMC
• Subjects: Apixaban; B cells; Blood–brain barrier; Cerebral Hemorrhage - chemically induced; Cerebral Hemorrhage - etiology; Dimethyl Fumarate - adverse effects; Dimethyl Fumarate - therapeutic use; Disease-modifying drugs; Diseases; Fingolimod Hydrochloride - adverse effects; Fingolimod Hydrochloride - therapeutic use; Health aspects; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Intracerebral haemorrhage; Medical research; Medicine, Experimental; Mitoxantrone - adverse effects; Mitoxantrone - therapeutic use; Mitoxantrone hydrochloride; Mortality; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - drug therapy; Neuroinflammation; Neurological complications; Pharmacotherapy in MS; Multiple sclerosis; Intracerebral haemorrhage; CNS immunity; Neurological complications; Neuroinflammation; Disease-modifying drugs; Blood–brain barrier
• ISSN: 2047-783X; 0949-2321; 2047-783X
• DOI: 10.1186/s40001-024-01945-x

Multiple Sclerosis (MS) is a complex autoimmune disorder that significantly impacts the central nervous system, leading to a range of complications. While intracranial haemorrhage (ICH) is a rare but highly morbid complication, more common CNS complications include progressive multifocal leukoencephalopathy (PML) and other CNS infections. This severe form of stroke, known for its high morbidity and mortality rates, presents a critical challenge in the management of MS. The use of disease-modifying drugs (DMDs) in treating MS introduces a nuanced aspect to patient care, with certain medications like Dimethyl Fumarate and Fingolimod showing potential in reducing the risk of ICH, while others such as Alemtuzumab and Mitoxantrone are associated with an increased risk. Understanding the intricate relationship between these DMDs, the pathophysiological mechanisms of ICH, and the individualised aspects of each patient's condition is paramount. Factors such as genetic predispositions, existing comorbidities, and lifestyle choices play a crucial role in tailoring treatment approaches, emphasising the importance of a personalised, vigilant therapeutic strategy. The necessity for ongoing and detailed research cannot be overstated. It is crucial to explore the long-term effects of DMDs on ICH occurrence and prognosis in MS patients, aiming to refine clinical practices and promote patient-centric, informed therapeutic decisions. This approach ensures that the management of MS is not only comprehensive but also adaptable to the evolving understanding of the disease and its treatments.