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In Austria, only certified MS centers are authorized to prescribe DMT and are obliged to enter patient data into the Austrian MS Therapy Registry (AMSTR). Here, we report the safety profiles of different DMT documented in this registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adverse events (AE) data from the AMSTR, collected at least biannually from August 2006 to July 2025, were extracted. AE were classified by system organ classes according to the Medical Dictionary for Regulatory Activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This analysis included 7913 patients (67.7% female, median age 37\u00a0years [IQ 29\u201345]), with the majority receiving dimethyl fumarate (2572\/7913, 32.5%), followed by fingolimod (2129\/7913, 26.9%) and natalizumab (2021\/7913, 25.5%). For alemtuzumab, the most frequent AE were immune-related (41\/90, 45.5%) including thyroid disorders (24\/90, 26.7%). For cladribine, natalizumab, ocrelizumab and ofatumumab, infections constituted the most common AE (21\/458, 4.6%; 123\/2021, 6.1%; 27\/698, 3.9%; 16\/792, 2%). Gastrointestinal AE were most frequently observed with dimethyl fumarate and teriflunomide (364\/2572, 14.2%, and 78\/781, 10%, respectively), whereas AE related to the blood system were most common with sphingosine-1 phosphate receptor modulators (S1P-modulators; fingolimod: 245\/2129, 11.5%). Regarding neoplasms, all DMT showed low rates, though S1P-modulators had the highest (fingolimod 31\/2129, 1.4%\u201413\/31 [42%] basal cell carcinomas).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The safety data from the AMSTR do not reveal any new safety issues, particularly regarding neoplasms and infections. Hence, people with MS as well as their treating neurologists are reassured to continue treatment with DMT, as the benefit-risk profile of DMT could be reaffirmed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-025-13473-7","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T15:15:50Z","timestamp":1763565350000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety of disease-modifying therapies in multiple sclerosis: real-world data from the Austrian MS Treatment Registry (AMSTR)"],"prefix":"10.1007","volume":"272","author":[{"given":"Tobias","family":"Monschein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Untersteiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Ponleitner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik","family":"Krajnc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Zrzavy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Bsteh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulus","family":"Rommer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kornek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Enzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Di Pauli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Guger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-8635","authenticated-orcid":false,"given":"Fritz","family":"Leutmezer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Austrian MS Treatment Registry (AMSTR)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"13473_CR1","doi-asserted-by":"publisher","first-page":"1816","DOI":"10.1177\/1352458520970841","volume":"26","author":"C Walton","year":"2020","unstructured":"Walton C, King R, Rechtman L et al (2020) Rising prevalence of multiple sclerosis worldwide: insights from the atlas of MS, third edition. 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He has received unrestricted research grants from BMS and Novartis. He serves on the Executive Committee of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Board of Directors of the International Multiple Sclerosis VisualSystem Consortium (IMSVISUAL).\n                      Paulus Rommer:\n                      has received honoraria for consultancy\/speaking from AbbVie, Allmiral, Alexion, Biogen, Merck, Novartis, Roche, Sandoz, Sanofi Genzyme, has received research grants from Amicus, Biogen, Merck, Roche.\n                      Barbara Kornek:\n                      has received honoraria for speaking and for consulting from Biogen, Celgene\/BMS, GSK, Johnson&Johnson, Merck, Novartis, Roche, Teva and Sanofi-Genzyme outside of the submitted work. No conflict of interest with respect to the present study.\n                      Christian Enzinger:\n                      received funding for travel and speaker honoraria from Biogen, Bayer, Celgene\/BMS, Merck, Novartis, Roche, Shire, Genzyme and Teva Pharmaceutical Industries Ltd.\/sanofi-aventis; research support from Merck Serono, Biogen, and Teva Pharmaceutical Industries Ltd.\/sanofi-aventis; serving on scientific advisory boards for Bayer, Biogen, Celgene, Merck, Novartis, Roche and Teva Pharmaceutical Industries Ltd.\/sanofi-aventis.\u00a0\n                      Franziska Di Pauli:\n                      has participated in meetings sponsored by, received honoraria (lectures, advisory boards, consultations) or travel funding from Amgen, Almirall, Bayer, Biogen, Celgene\/BMS, Janssen, Merck, Novartis, Sandoz, Sanofi-Genzyme, Roche, and Teva.\n                      J\u00f6rg Kraus:\n                      has received Consulting and\/or research funding and\/or educational support from A-med, Alexion, Almirall, Amgen, Apurano, Aurimod, Bayer, Biogen, Celgene\/Bristol Myers Squibb, Gr\u00fcnenthal, Horizon, Lilly, MedDay, Medtronic, Merck, Neuraxpharm, Novartis, Perimed, Pfizer, Roche, Sanofi- Aventis, Shire, and TEVA ratiopharm.\n                      Michael Guger:\n                      received support and honoraria for research, consultation, lectures and education from Alexion, Almirall, Bayer, Biogen, Bristol-Myers-Squibb, Celgene\/BMS, Genzyme, Horizon, Janssen-Cilag, MedDay, Merck, Neuraxpharm, Novartis, Roche, Sanofi Aventis, and TEVA ratiopharm.\n                      Fritz Leutmezer:\n                      has participated in meetings sponsored by, received speaker honoraria or travel funding from Actelion, Almirall, Biogen, Celgene\/BMS, Johnson&Johnson, MedDay, Merck, Novartis, Roche, Sanofi-Genzyme and Teva, and received honoraria for consulting Biogen, Celgene, Merck, Novartis, Roche, Sanofi-Genzyme and Teva.\n                      Thomas Berger:\n                      has participated in meetings sponsored by and received honoraria (lectures, advisory boards, consultations) from pharmaceutical companies marketing treatments for MS: Allergan, Bayer, Biogen, Bionorica, BMS, Genesis, GSK, GW\/Jazz Pharma, Horizon, Janssen-Cilag, MedDay, Merck, Novartis, Octapharma, Roche, Sandoz, Sanofi-Genzyme, Teva and UCB. His institution has received financial support in the past 12\u00a0months by unrestricted research grants (Biogen, Bayer, BMS\/Celgene, Merck, Novartis, Roche, Sanofi-Genzyme, Teva and for participation in clinical trials in multiple sclerosis sponsored by Alexion, Bayer, Biogen, Merck, Novartis, Octapharma, Roche, Sanofi-Genzyme, Teva.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"774"}}