COVID-19 in Patients with Multiple Sclerosis: Associations with Disease-Modifying Therapies.
Adolescent
Adult
Black or African American
/ statistics & numerical data
Aged
Aged, 80 and over
Alemtuzumab
/ therapeutic use
Azathioprine
/ therapeutic use
COVID-19
/ epidemiology
Cladribine
/ therapeutic use
Comorbidity
Crotonates
/ therapeutic use
Cyclophosphamide
/ therapeutic use
Cyclosporine
/ therapeutic use
Databases, Factual
Dimethyl Fumarate
/ therapeutic use
Female
Fingolimod Hydrochloride
/ therapeutic use
Hospitalization
/ statistics & numerical data
Humans
Hydroxybutyrates
Immunologic Factors
/ therapeutic use
Immunosuppressive Agents
/ therapeutic use
Incidence
Interferon-beta
/ therapeutic use
Logistic Models
Lupus Erythematosus, Systemic
/ drug therapy
Male
Methotrexate
/ therapeutic use
Middle Aged
Mitoxantrone
/ therapeutic use
Multiple Sclerosis
/ drug therapy
Mycophenolic Acid
/ therapeutic use
Natalizumab
/ therapeutic use
Nitriles
Obesity
/ epidemiology
Risk Factors
Rituximab
/ therapeutic use
SARS-CoV-2
Toluidines
/ therapeutic use
United States
/ epidemiology
White People
/ statistics & numerical data
Young Adult
Journal
CNS drugs
ISSN: 1179-1934
Titre abrégé: CNS Drugs
Pays: New Zealand
ID NLM: 9431220
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
accepted:
10
03
2021
pubmed:
21
3
2021
medline:
13
4
2021
entrez:
20
3
2021
Statut:
ppublish
Résumé
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) target immunity and have the potential to increase the risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and alter its clinical course. We assessed these risks in patients with MS (PwMS). The objective of this study was to describe the overall risk of coronavirus disease 2019 (COVID-19) infection, severe disease course, and potential population-level predictors of COVID-19 infection in PwMS, and to provide a context using a cohort of patients with systemic lupus erythematosus (SLE). In addition, the association of different MS DMTs with the incidence and clinical course of COVID-19 was evaluated. Safety data from the Biogen Global Safety Database are also presented on reported cases of COVID-19 in patients treated with Biogen MS therapies. The IBM 30,478 PwMS with an open DMT prescription were identified within Explorys; 344 were COVID-19 positive. The most significant risk factors for acquiring COVID-19 were comorbidity score ≥ 1, body mass index ≥ 30, and Black/African ancestry. Similar risk factors were also identified for patients with SLE. Patients with MS were less likely to develop COVID-19 when treated with interferons (0.61%) and glatiramer acetate (0.51%), vs all other MS DMTs (both p < 0.001); anti-CD20 therapy was associated with the highest risk (3.45%; p < 0.0001). In the Biogen Global Safety Database, we identified 1217 patients who were COVID-19 positive treated with intramuscular interferon beta-1a, peginterferon beta-1a, natalizumab, dimethyl fumarate, diroximel fumarate, or fampridine. Comorbidities, obesity, and Black/African ancestry, but not age, were associated with a higher risk of SARS-CoV-2 infection in PwMS. Interferons and glatiramer acetate were associated with a reduced COVID-19 risk, whereas anti-CD20 therapies were associated with an increased risk, within the treated MS cohort. COVID-19 safety reports for patients receiving Biogen MS therapies were consistent with the Explorys database and MS literature, illustrating the replicability and power of this approach.
Sections du résumé
BACKGROUND
Disease-modifying therapies (DMTs) for multiple sclerosis (MS) target immunity and have the potential to increase the risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and alter its clinical course. We assessed these risks in patients with MS (PwMS).
OBJECTIVE
The objective of this study was to describe the overall risk of coronavirus disease 2019 (COVID-19) infection, severe disease course, and potential population-level predictors of COVID-19 infection in PwMS, and to provide a context using a cohort of patients with systemic lupus erythematosus (SLE). In addition, the association of different MS DMTs with the incidence and clinical course of COVID-19 was evaluated. Safety data from the Biogen Global Safety Database are also presented on reported cases of COVID-19 in patients treated with Biogen MS therapies.
METHODS
The IBM
RESULTS
30,478 PwMS with an open DMT prescription were identified within Explorys; 344 were COVID-19 positive. The most significant risk factors for acquiring COVID-19 were comorbidity score ≥ 1, body mass index ≥ 30, and Black/African ancestry. Similar risk factors were also identified for patients with SLE. Patients with MS were less likely to develop COVID-19 when treated with interferons (0.61%) and glatiramer acetate (0.51%), vs all other MS DMTs (both p < 0.001); anti-CD20 therapy was associated with the highest risk (3.45%; p < 0.0001). In the Biogen Global Safety Database, we identified 1217 patients who were COVID-19 positive treated with intramuscular interferon beta-1a, peginterferon beta-1a, natalizumab, dimethyl fumarate, diroximel fumarate, or fampridine.
CONCLUSIONS
Comorbidities, obesity, and Black/African ancestry, but not age, were associated with a higher risk of SARS-CoV-2 infection in PwMS. Interferons and glatiramer acetate were associated with a reduced COVID-19 risk, whereas anti-CD20 therapies were associated with an increased risk, within the treated MS cohort. COVID-19 safety reports for patients receiving Biogen MS therapies were consistent with the Explorys database and MS literature, illustrating the replicability and power of this approach.
Identifiants
pubmed: 33743151
doi: 10.1007/s40263-021-00804-1
pii: 10.1007/s40263-021-00804-1
pmc: PMC7980129
doi:
Substances chimiques
Crotonates
0
Hydroxybutyrates
0
Immunologic Factors
0
Immunosuppressive Agents
0
Natalizumab
0
Nitriles
0
Toluidines
0
teriflunomide
1C058IKG3B
Alemtuzumab
3A189DH42V
Cladribine
47M74X9YT5
Rituximab
4F4X42SYQ6
Interferon-beta
77238-31-4
Cyclosporine
83HN0GTJ6D
Cyclophosphamide
8N3DW7272P
Mitoxantrone
BZ114NVM5P
Dimethyl Fumarate
FO2303MNI2
Fingolimod Hydrochloride
G926EC510T
Mycophenolic Acid
HU9DX48N0T
Azathioprine
MRK240IY2L
Methotrexate
YL5FZ2Y5U1
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
317-330Références
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