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Region Hovedstaden - en del af Københavns Universitetshospital

Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Steve Simpson-Yap
  • Ashkan Pirmani
  • Tomas Kalincik
  • Edward De Brouwer
  • Lotte Geys
  • Tina Parciak
  • Anne Helme
  • Nick Rijke
  • Jan A Hillert
  • Yves Moreau
  • Gilles Edan
  • Sifat Sharmin
  • Tim Spelman
  • Robert McBurney
  • Hollie Schmidt
  • Arnfin B Bergmann
  • Stefan Braune
  • Alexander Stahmann
  • Rod M Middleton
  • Amber Salter
  • Bruce Bebo
  • Anneke Van der Walt
  • Helmut Butzkueven
  • Serkan Ozakbas
  • Cavit Boz
  • Rana Karabudak
  • Raed Alroughani
  • Juan I Rojas
  • Ingrid A van der Mei
  • Guilherme Sciascia do Olival
  • Melinda Magyari
  • Ricardo N Alonso
  • Richard S Nicholas
  • Anibal S Chertcoff
  • Ana Zabalza de Torres
  • Georgina Arrambide
  • Nupur Nag
  • Annabel Descamps
  • Lars Costers
  • Ruth Dobson
  • Aleisha Miller
  • Paulo Rodrigues
  • Vesna Prčkovska
  • Giancarlo Comi
  • Liesbet M Peeters
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BACKGROUND AND OBJECTIVES: Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed.

METHODS: Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab.

RESULTS: Of 5,648 patients, 922 (16.6%) with suspected and 4,646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1-7] and 7% [95% CI 4-11]), ICU/artificial ventilation (2% [95% CI 0-4] and 4% [95% CI 2-6]), and death (1% [95% CI 0-2] and 2% [95% CI 1-4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2-8), 3% (95% CI 1-5), and 1% (95% CI 0-3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19.

DISCUSSION: Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.

TidsskriftNeurology: Neuroimmunology and NeuroInflammation
Udgave nummer6
StatusUdgivet - nov. 2022

Bibliografisk note

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

ID: 80465148