Multiple sclerosis and rheumatic diseases: Rheumatoid arthritis, antiphospholipid syndrome, and systemic lupus erythematosus

Abstract

Introduction

Multiple sclerosis (MS) may be associated with a range of rheumatic diseases. Rheumatoid arthritis is a chronic inflammatory disease typically affecting small- and medium-size joints. MS has been associated with antiphospholipid syndrome.

Development

The treatment of these patients must be carefully established, considering the presence of neurological symptoms or central nervous system comorbidities. Patients with MS and rheumatoid arthritis should not be treated with TNF inhibitors, as these may exacerbate the neurological symptoms. Most biological drugs may favour opportunistic infections of the central nervous system; therefore, patients developing neurological symptoms should undergo comprehensive examination, and biological treatment should be adapted according to the results.

Conclusions

We summarise the main recommendations for the treatment of patients with MS associated with rheumatic diseases.