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Open Access 01-02-2025 | Multiple Sclerosis | Review

Cancer in multiple sclerosis patients following prolonged exposure to disease-modifying therapies (DMTs): a systematic review and meta-analysis

Authors: Vasileios Giannopapas, Vassiliki Smyrni, Dimitrios K. Kitsos, Maria Ioanna Stefanou, Aikaterini Theodorou, John S. Tzartos, Georgios Tsivgoulis, Sotirios Giannopoulos

Published in: Journal of Neurology | Issue 2/2025

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Abstract

Introduction

The current literature on the prevalence and potential association between disease-modifying therapies (DMTs) and cancer risk in the MS population has yielded mixed findings.

Methods

This study aimed to estimate cancer prevalence and cancer risk in patients with MS (PwMS) under prolonged DMT exposure. Database search include: MEDLINE PUBMED, SCOPUS, and Google Scholar.

Results

A total of 13 studies involving 333,779 PwMS were included, reporting cancer events over periods ranging from 6 to 32 years. The aggregated pooled prevalence of cancer events in MS patients receiving disease-modifying therapies (DMTs) was 3.8% (95% CI 2.6, 5.2%), with substantial heterogeneity (I2 = 99.7%, p = 0). Two studies compared cancer events in MS patients who received DMTs versus those who did not. The relative risk of cancer associated with DMTs was 0.8 (95% CI 0.59–1.31, I2 = 93.6%, p = 0.53), indicating no significant increase in cancer risk due to DMTs. Breast and basal cell carcinomas had a high prevalence (18.4% and 11.3, respectively) in PwMS under DMTs.

Conclusion

This study reports a 3.8% pooled prevalence of cancer in PwMS receiving DMTs. The findings of this study suggest that DMTs alone do not increase cancer risk in PwMS. Breast cancer and basal cell carcinoma had the highest prevalence among the different types of cancer.
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Metadata
Title
Cancer in multiple sclerosis patients following prolonged exposure to disease-modifying therapies (DMTs): a systematic review and meta-analysis
Authors
Vasileios Giannopapas
Vassiliki Smyrni
Dimitrios K. Kitsos
Maria Ioanna Stefanou
Aikaterini Theodorou
John S. Tzartos
Georgios Tsivgoulis
Sotirios Giannopoulos
Publication date
01-02-2025
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 2/2025
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-024-12882-4

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