Disease-modifying agents for multiple sclerosis do not elevate cancer risk

Several disease-modifying therapies (DMTs) for multiple sclerosis (MS) do not pose an increased risk of cancer, a study has shown.

In this study, the researchers sought to determine whether the prescription of DMTs for patients with MS elevates the risk of reporting cancer. They extracted data from the Food and Drug Administration Adverse Event Reporting System from 2004 to 2020.

After cleaning the data, the researchers calculated the crude (cROR) and adjusted reported odds ratios (aROR) for cancer, with interferon beta-1a as the reference drug. They also performed sensitivity analyses to assess the group of reports with multiple registered DMTs, the effect of indication restriction, and the results when using the rest of the DMTs as reference.

The aROR values for malignant tumours, adjusted to age, gender, and concomitant medications, were 0.46 (95 percent confidence interval [CI], 0.18‒0.95) with cladribine, 0.30 (95 percent CI, 0.27‒0.34) with dimethyl fumarate, 0.61 (95 percent CI, 0.53‒0.70) with finglimod, 0.50 (95 percent CI, 0.43‒0.58) with glatiramer, 0.84 (95 percent CI, 0.64‒1.08) with alemtuzumab, and 0.49 (95 percent CI, 0.42‒0.56) with interferon beta-1b.

With natalizumab, ocrelizumab, peginterferon beta-1a, Siponimod, and teriflunomide, the aROR values were 0.36 (95 percent CI, 0.34‒0.39), 0.48 (95 percent CI, 0.29‒0.74), 0.35 (95 percent CI, 0.26‒0.48), 0.89 (95 percent CI, 0.47‒1.54), and 0.25 (95 percent CI, 0.21‒0.30), respectively.

In sensitivity analysis, aROR for interferon beta-1a and peginterferon beta-1a was 2.60 (95 percent CI, 2.47‒2.74; p<0.001) and for alemtuzumab was 1.47 (95 percent CI, 1.13‒1.88; I=0.003).

A potential safety signal observed with interferon beta-1a and alemtuzumab warrants further assessment with more robust evidence, according to the researchers.