Pharmacovigilance during treatment of multiple sclerosis: Early recognition of CNS complications

Martijn T. Wijburg*, Clemens Warnke, Christopher McGuigan, Igor J. Koralnik, Frederik Barkhof, Joep Killestein, Mike P. Wattjes

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


An increasing number of highly effective disease-modifying therapies for people with multiple sclerosis (MS) have recently gained marketing approval. While the beneficial effects of these drugs in terms of clinical and imaging outcome measures is welcomed, these therapeutics are associated with substance-specific or group-specific adverse events that include severe and fatal complications. These adverse events comprise both infectious and non-infectious complications that can occur within, or outside of the central nervous system (CNS). Awareness and risk assessment strategies thus require interdisciplinary management, and robust clinical and paraclinical surveillance strategies. In this review, we discuss the current role of MRI in safety monitoring during pharmacovigilance of patients treated with (selective) immune suppressive therapies for MS. MRI, particularly brain MRI, has a pivotal role in the early diagnosis of CNS complications that potentially are severely debilitating and may even be lethal. Early recognition of such CNS complications may improve functional outcome and survival, and thus knowledge on MRI features of treatment-associated complications is of paramount importance to MS clinicians, but also of relevance to general neurologists and radiologists.

Original languageEnglish (US)
Pages (from-to)177-188
Number of pages12
JournalJournal of Neurology, Neurosurgery and Psychiatry
Issue number2
StatePublished - Feb 1 2021


  • MRI
  • multiple sclerosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery


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