2233 Updated results of the COVID-19 in MS global data sharing initiative: anti-CD20 DMTs deleterious for COVID-19 severity but interferons not protective among people with MS
Year: 2022
Type: conference-abstract
Abstract: Objectives Some disease-modifying therapies (DMTs) have been associated with COVID-19 severity in people with 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 dataset of 5,648 patients with suspected/confirmed COVID-19. COVID-19 severity outcomes (hospitalisation, admission to ICU, requiring artificial ventilation, death) assessed using multilevel mixed-effect ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were compared to glatiramer acetate, dimethyl fumarate, pooled other DMTs, and natalizumab. Results Of 5,648 patients (83.4% confirmed COVID-19) were included. Compared to glatiramer acetate, ocrelizumab and rituximab were associated with higher probability of hospitalisation (4%(95%CI=1–7) & 7%(95%CI=4–11)), ICU/artificial ventilation (2%(95%CI=0–4) & 4%(95%CI=2–6)), and death (1%(95%CI=0–2) & 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 three respective levels of COVID-19 severity than glatiramer acetate. Compared to pooled other DMTs and to natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. Evaluation of interferon associations with COVID-19 severity found these only apparent in comparison with the untreated but not vs individual or pooled other DMTs. All associations persisted/enhanced on restriction to confirmed COVID-19. Conclusions Analysing the largest international real-world dataset of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab) are associated with more severe course of COVID-19, while interferon-based DMTs have no intrinsic protective benefit from other treatment.
Source: BMJ Neurology Open
Authors: Steve Simpson-Yap, Ashkan Pirmani, Tomas Kalincik, Edward De Brouwer, Lotte Geys, Tina Parciak, Anne Helme, Nick Rijke, Jan Hillert, Yves Moreau, Gilles Edan, Tim Spelman, Sifat Sharmin, Robert McBurney, Hollie Schmidt, Arnfin Bergmann, Stefan Braune, Alexander Stahmann, Amber Salter, Bruce Bebo, Anneke Van der Walt, Helmut Butzkueven, Serkan Ozakbas, Rana Karabudak, Raed Alroughani, Juan I Rojas, Ingrid Van Der Mei, Guilherme Sciascia do Olival, Melinda Magyari, Ricardo Alonso, Richard Nicholas, Anibal Chertcoff, Ana Zabalza, Georgina Arrambide, Nupur Nag, Annabel Descamps, Lars Costers, Ruth Dobson, Aleisha Miller, Paolo Rodriguez, Vesna Prchkovska, Giancarlo Comi, Liesbet Peeters
Institutions: University of Tasmania, The University of Melbourne, Menzies Institute for Medical Research, Hasselt University, KU Leuven, The Royal Melbourne Hospital, Universitätsmedizin Göttingen, Multiple Sclerosis Society, Hôpital Pontchaillou, Karolinska Institutet, National Multiple Sclerosis Society, Washington University in St. Louis, Monash University, Dokuz Eylül University, Hacettepe University, Amiri Hospital, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Rigshospitalet, Danish Multiple Sclerosis Center, Hospital Ramos Mejía, Swansea University, Imperial College London, Hospital Británico de Buenos Aires, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Centre d'Esclerosi Múltiple de Catalunya, Icometrix (Belgium), Queen Mary University of London, Vita-Salute San Raffaele University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4391476495