Genitourinary Infectious Complications in Patients with Multiple Sclerosis and their Association with Disease Modifying Therapies

Urinary tract infection (UTI) and vaginitis are common urological conditions societies have dealt with for decades. UTIs can have certain predisposing factors. Multiple sclerosis (MS) and Disease-Modifying Therapies (DMTs), primary MS treatment regimens, demonstrate the effects of MS and DMTs on urological complications.

This paper is a cohort study conducted from June 2020 to October 2021 using prospectively collected data from Every patient registered at Tehran's Multiple Sclerosis Referral Research Center. This study's inclusion criteria consisted of patients diagnosed with MS based on McDonald criteria and exposed to DMTs for at least six months. The exclusion criteria were being under 18 years of age, diagnosis change during the study, and mortality.

We inducted a total of 905 patients into this study. We attempted 1:6 nearest neighbor propensity score matching without replacement with a propensity score estimated using logistic regression of the group on age and sex. 41 cases and 96 controls were discarded due to missing values for age and sex. Following matching, 11 more participants from the control group were discarded. Finally, data from 798 cases and 4788 control participants were analyzed. Urinary tract infection rate increased when patients were exposed to Rituximab, Beta1b, Fingolimod, Glatiramer, and Azathioprine (P-value<0.05). Vaginitis incidence was increased when patients were exposed to Fingolimod and Glatiramer Acetate (P-value<0.05). EDSS and MS duration affected the UTI risk (P-value<0.05).

MS and the use of DMTs can result in an increased rate of urological infections. Healthcare workers should screen the MS Patients for UTI and vaginitis more often to prevent disease progression or choose the proper treatment regimen.