title: Efficacy of vaccination against influenza in patients with multiple sclerosis: The role of concomitant therapies.
abstract: Multiple sclerosis is a chronic progressive demyelinating disease affecting over 2.1 million patients worldwide. Patients affected by MS are exposed to an increased risk of infection from communicable diseases, which may lead to severe disease relapses. Studies have analysed the issue of vaccination of MS-affected patients. These studies, however, deal mostly with safety-related issues documenting that most vaccines have been proven to be safe in MS patients and that vaccination is not associated with an increased risk of relapses. By contrast, evidence on the efficacy is comparatively scant and not yet systematised in a comprehensive picture. This aspect is however important, as both MS and its treatment alter the immune responses, a situation that may be associated with a reduced vaccine efficacy. We have now reviewed the literature and assessed the effects of the therapy for MS on vaccine efficacy; we focused on the vaccine against influenza as for the other vaccines the information is still too scant. The majority of drugs appear not associated with a reduced response to vaccination against influenza, with the notable exception of mitoxantrone and glatiramer acetate. For a few drugs, among which natalizumab, information is not sufficiently clear and additional studies are needed to draw a definite conclusion. These results highlight the importance to evaluate the efficacy of vaccination in patients treated with immunosuppressant drugs.
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital "Luigi Sacco", Università di Milano, Via GB Grassi 74, 20157 Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pellegrino
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital "Luigi Sacco", Università di Milano, Via GB Grassi 74, 20157 Milan, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Carnovale
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital "Luigi Sacco", Università di Milano, Via GB Grassi 74, 20157 Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Perrone
authors.affiliation: Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Lecco, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Antoniazzi
authors.affiliation: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital "Luigi Sacco", Università di Milano, Via GB Grassi 74, 20157 Milan, Italy. Electronic address: sonia.radice@unimi.it.
authors.forename: Sonia
authors.initials: S
authors.lastname: Radice
authors.affiliation: Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Lecco, Italy; Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital "Luigi Sacco",⁎
authors.forename: Emilio
authors.initials: E
authors.lastname: Clementi
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068717:Glatiramer Acetate; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D008942:Mitoxantrone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D000069442:Natalizumab; D010455:Peptides / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D000069442:Natalizumab; D010455:Peptides; D000068717:Glatiramer Acetate; D008942:Mitoxantrone
keywords: Efficacy; Multiple sclerosis; Natalizumab; Vaccine