COVID-19 in ocrelizumab-treated people with multiple sclerosis

Hughes, Richard A.; Whitley, L; Fitovski, Kocho; Schneble, Hans-Martin; Muros, Erwan; Sauter, Annette; Craveiro, Licínio; Dillon, Paul; Bonati, Ulrike; Jessop, Nikki; Pedotti, Rosetta; Koendgen, Harold

doi:10.1016/j.msard.2020.102725

Cited by 69 publications

(74 citation statements)

References 62 publications

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“…However, no concrete evidence until now supports or denies this claim. Most of treated PwMS infected by COVID-19 disease had a favourable clinical outcome [22].…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab in Covid era

Iovino

Olivieri

Aruta

et al. 2021

Multiple Sclerosis and Related Disorders

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…However, no concrete evidence until now supports or denies this claim. Most of treated PwMS infected by COVID-19 disease had a favourable clinical outcome [22].…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab in Covid era

Iovino

Olivieri

Aruta

et al. 2021

Multiple Sclerosis and Related Disorders

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“…[8][9][10] However, significant methodological limitations that constrain interpretation include unknown number of rituximab/ocrelizumab-treated persons with MS (pwMS) at risk, [3][4][5][6][7][8][9][10] lack of comparison to the general population, [3][4][5][6][7][8][9][10] incomplete ascertainment of comorbidities, [3][4][5][6][7][8][9][10] inability to account for geographic variation in COVID-19 outbreaks, 3,7,8,10 reliance on registries, 3,8,10 and/or inclusion of unconfirmed COVID-19 cases with non-specific symptoms. 3,4,7,9 The aim of this study was to determine whether rituximab-treated pwMS were at higher risk of more severe COVID-19 infection compared to the general population, and if so, whether this is best explained by known risk factors for moderate-to-severe COVID-19, MS-related disability, or rituximab treatment characteristics.…”

Section: Introductionmentioning

confidence: 99%

Multiple sclerosis, rituximab, and COVID‐19

Langer‐Gould

Smith²,

Li³

et al. 2021

Ann Clin Transl Neurol

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We conducted a retrospective cohort study in Kaiser Permanente Southern California from 1 January 2020 to 30 September 2020. We found that rituximab‐treated persons with multiple sclerosis (pwMS, n = 1895) were more likely be hospitalized (n = 8, 33.3%), but not die (n = 0) from COVID‐19, compared to the 4.81 million non‐MS population (5.8% and 1.4%, respectively). Time in months (adjusted OR = 0.32, 95% CI = 0.15–0.69, p = 0.0033) and receiving 1000 mg compared to lower doses at last infusion (adjusted OR = 6.28, 95% CI = 1.38–28.5, p = 0.0173) were independent predictors of COVID‐19 severity. Rituximab‐treated pwMS should be counseled to take extra precautions in the 5 months following each infusion. Using extended dosing intervals and lower doses could be considered.

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“…Critical evidence also was derived from pharmacovigilance studies, especially the Roche ® (Basel, Switzerland)/Genentech ® (San Francisco, CA, USA) global safety databases, with over 160,000 MS patients worldwide. We identified 1215 cases of confirmed ( n = 1042) or suspected ( n = 172) COVID-19 in MS patients treated with ocrelizumab [ 8 , 11 , 13 , 15 , 16 , 18 , 19 , 22 , 23 , 24 , 25 , 29 , 35 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ]. Thirty-five (2.8%) of these patients had a fatal outcome.…”

Section: Resultsmentioning

confidence: 99%

Multiple Sclerosis, Disease-Modifying Therapies and COVID-19: A Systematic Review on Immune Response and Vaccination Recommendations

et al. 2021

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Understanding the risks of COVID-19 in patients with Multiple Sclerosis (MS) receiving disease-modifying therapies (DMTs) and their immune reactions is vital to analyze vaccine response dynamics. A systematic review on COVID-19 course and outcomes in patients receiving different DMTs was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Emerging data on SARS-CoV-2 vaccines was used to elaborate recommendations. Data from 4417 patients suggest that MS per se do not portend a higher risk of severe COVID-19. As for the general population, advanced age, comorbidities, and higher disability significantly impact COVID-19 outcomes. Most DMTs have a negligible influence on COVID-19 incidence and outcome, while for those causing severe lymphopenia and hypogammaglobulinemia, such as anti-CD20 therapies, there might be a tendency of increased hospitalization, worse outcomes and a higher risk of re-infection. Blunted immune responses have been reported for many DMTs, with vaccination implications. Clinical evidence does not support an increased risk of MS relapse or vaccination failure, but vaccination timing needs to be individually tailored. For cladribine and alemtuzumab, it is recommended to wait 3–6 months after the last cycle until vaccination. For the general anti-CD20 therapies, vaccination must be deferred toward the end of the cycle and the next dose administered at least 4–6 weeks after completing vaccination. Serological status after vaccination is highly encouraged. Growing clinical evidence and continuous surveillance are extremely important to continue guiding future treatment strategies and vaccination protocols.

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COVID-19 in ocrelizumab-treated people with multiple sclerosis

Cited by 69 publications

References 62 publications

Alemtuzumab in Covid era

Alemtuzumab in Covid era

Multiple sclerosis, rituximab, and COVID‐19

Multiple Sclerosis, Disease-Modifying Therapies and COVID-19: A Systematic Review on Immune Response and Vaccination Recommendations

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