Appendicitis and multiple sclerosis disease-modifying therapies: a disproportionality analysis of the FDA adverse event reporting system.

BACKGROUND

Although appendicitis is one of the most common surgical emergencies and is related to immune function, its relation to multiple sclerosis (MS) disease-modifying therapies (DMTs) is unclear.

OBJECTIVE

To determine which, if any, MS DMTs are associated with disproportionally high appendicitis reporting using real-world data from the FDA Adverse Event Reporting System (FAERS).

RESULTS

We identified 965 reports of appendicitis associated with MS DMTs. A pooled analysis of all DMTs showed disproportionately high appendicitis reporting compared to all other FAERS medications (reporting odds ratio, 2.83; 95% confidence interval, 2.63-3.06; χ (Bhangu et al., 2015), 787.54). Ocrelizumab, ofatumumab, natalizumab, alemtuzumab, dimethyl and diroximel fumarate, cladribine, and peg- and interferon beta-1a all individually exhibited disproportionally high appendicitis reporting.

CONCLUSION

Patient counseling on early appendicitis warning signs and indications for urgent evaluation may be warranted for people with MS on DMTs.