Details

Autor(en) / Beteiligte

• Simpson-Yap, Steve
• Brouwer, Edward De
• Kalincik, Tomas
• Rijke, Nick
• Hillert, Jan
• Walton, Clare
• Edan, Gilles
• Spelman, Tim
• Geyes, Lotte
• Parciak, Tina
• Gautrais, Clément
• Lazovski, Nikola
• Pirmani, Ashkan
• Ardeshirdavani, Amin
• Forsberg, Lars
• Glaser, Anna
• McBurney, Robert
• Schmidt, Hollie
• Bergmann, Arnfin
• Braune, Stefan
• Stahmann, Alexander
• Middleton, Rodden
• Salter, Amber
• Fox, Robert
• van der Walt, Anneke
• Butzkueven, Helmut
• Rojas, Juan
• van der Mei, Ingrid
• Nag, Nupur
• Ivanov, Rumen
• Olival, Guilherme Sciascia do
• Dias, Alice Estavo
• Magyari, Melinda
• Brum, Doralina Guimarães
• Mendes, Maria Fernandes
• Alonso, Ricardo
• Nicholas, Richard
• Bauer, Johana
• Chertcoff, Anibal
• Zabalza, Ana
• Arrambide, Georgina
• Fidao, Alexander
• Comi, Giancarlo
• Peeters, Liesbet

Titel

1298Associations of DMT therapies with COVID-19 severity in multiple sclerosis

Ist Teil von

• International journal of epidemiology, 2021-09, Vol.50 (Supplement_1)

Erscheinungsjahr

2021

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background People with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS. Methods Data from 12 data-sources in 28 countries were aggregated (sources could include patients from 1-12 countries). Demographic (age, sex), clinical (MS phenotype, disability), and DMT (untreated, alemtuzumab, cladribine, dimethyl-fumarate, glatiramer-acetate, interferon, natalizumab, ocrelizumab, rituximab, siponimod, other) covariates were queried, alongside COVID-19 hospitalisation, admission to ICU, requiring artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression, adjusted for age, sex, MS phenotype, and EDSS. Results 657 (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analysed. Among suspected+confirmed/confirmed-only COVID-19, 20.9%/26.9% were hospitalised, 5.4%/7.2% were admitted to ICU, 4.1%/5.4% required artificial ventilation, and 3.2%/3.9% died. Older age, progressive MS-phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl-fumarate, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.56,95%CI=1.01-2.41; aOR=2.43,95%CI=1.48-4.02) and ICU admission (aOR=2.30,95%CI=0.98-5.39; aOR=3.93,95%CI=1.56-9.89), though only rituximab was associated with higher risk of artificial ventilation (aOR=4.00,95%CI=1.54-10.39). Importantly, associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death. Conclusions Despite the cross-sectional design of this study, the internal and external consistency of these results with prior studies suggests their use may be a risk factor for more severe COVID-19. Key messages Anti-CD20 DMTs may be associated with worse COVID-19 severity amongst people with multiple sclerosis.