October 07, 2021
Rituximab and ocrelizumab appeared to increase risk for adverse outcomes among patients with MS and COVID-19, according to study results published in Neurology.
A prior study suggested disease-modifying therapies that involve immunomodulation or immunosuppression for treating MS may increase susceptibility. Other studies showed patients treated with rituximab or ocrelizumab had increased risk for severe COVID-19 and higher frequencies of hospitalization.
“Large and geographically inclusive cohorts are required to assess the risk of severe COVID-19 for specific DMTs [disease-modifying therapies],” Steve Simpson-Yap, PhD, MPH, of the department of medicine at the University of Melbourne in Australia, and colleagues wrote. “Accordingly, we established a global data-sharing initiative to investigate characteristics of COVID-19 severity in people with MS.
“We hypothesized that older age, progressive MS-phenotype and higher disability were associated with more severe COVID-19, while immunosuppressive DMTs (alemtuzumab/cladribine/fingolimod/ocrelizumab/rituximab) would be deleterious but those with less infection risk (interferons/glatiramer-acetate) would be associated with a less severe COVID-19,” they added.
Researchers aggregated data from 12 sources across 28 countries. They collected data on demographic, DMT and clinical covariates, as well as on COVID-19 severity outcomes, hospitalization, ICU admission, requiring artificial ventilation and death. They also used multilevel mixed-effects logistic regression that controlled for age, sex, MS-phenotype and Expanded Disability Status Scale to investigate characteristics of outcomes among patients with suspected (n = 657) or confirmed (1,683) COVID-19.
Results showed the following outcomes for suspected plus confirmed COVID-19 patients and confirmed-only COVID-19 patients, respectively: