TY - JOUR
T1 - Updated Results of the COVID-19 in MS Global Data Sharing Initiative
T2 - Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity
AU - Simpson-Yap, Steve
AU - Pirmani, Ashkan
AU - Kalincik, Tomas
AU - De Brouwer, Edward
AU - Geys, Lotte
AU - Parciak, Tina
AU - Helme, Anne
AU - Rijke, Nick
AU - Hillert, Jan A.
AU - Moreau, Yves
AU - Edan, Gilles
AU - Sharmin, Sifat
AU - Spelman, Tim
AU - Mcburney, Robert
AU - Schmidt, Hollie
AU - Bergmann, Arnfin B.
AU - Braune, Stefan
AU - Stahmann, Alexander
AU - Middleton, Rod M.
AU - Salter, Amber
AU - Bebo, Bruce
AU - Van Der Walt, Anneke
AU - Butzkueven, Helmut
AU - Ozakbas, Serkan
AU - Boz, Cavit
AU - Karabudak, Rana
AU - Alroughani, Raed
AU - Rojas, Juan I.
AU - Van Der Mei, Ingrid A.
AU - Sciascia Do Olival, Guilherme
AU - Magyari, Melinda
AU - Alonso, Ricardo N.
AU - Nicholas, Richard S.
AU - Chertcoff, Anibal S.
AU - De Torres, Ana Zabalza
AU - Arrambide, Georgina
AU - Nag, Nupur
AU - Descamps, Annabel
AU - Costers, Lars
AU - Dobson, Ruth
AU - Miller, Aleisha
AU - Rodrigues, Paulo
AU - Prčkovska, Vesna
AU - Comi, Giancarlo
AU - Peeters, Liesbet M.
N1 - Publisher Copyright:
© 2022 American Academy of Neurology.
PY - 2022/11/29
Y1 - 2022/11/29
N2 - Background and Objective s 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.DiscussionAnalyzing 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.
AB - Background and Objective s 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.DiscussionAnalyzing 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.
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U2 - 10.1212/NXI.0000000000200021
DO - 10.1212/NXI.0000000000200021
M3 - Article
C2 - 36038263
AN - SCOPUS:85135166365
SN - 2332-7812
VL - 9
JO - Neurology: Neuroimmunology and NeuroInflammation
JF - Neurology: Neuroimmunology and NeuroInflammation
IS - 6
M1 - e200021
ER -