Should interferons take front stage as an essential MS disease-modifying therapy in the era of coronavirus disease 2019?

Maguire, Cole; Frohman, Teresa C.; Zamvil, Scott S.; Frohman, Elliot M.; Melamed, Esther

doi:10.1212/nxi.0000000000000811

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…While the current consensus is to continue disease-modifying treatments, SARS-CoV-2 infected MS patients may benefit from. interferon therapy, suggesting some alterations in the MS treatment regimen may enhance outcomes [159,160].…”

Section: Challenges For the Clinical Management Of Covid-19mentioning

confidence: 99%

Neurological consequences of COVID-19: what have we learned and where do we go from here?

Jarrahi

Ahluwalia

Khodadadi

et al. 2020

J Neuroinflammation

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The coronavirus disease-19 (COVID-19) pandemic is an unprecedented worldwide health crisis. COVID-19 is caused by SARS-CoV-2, a highly infectious pathogen that is genetically similar to SARS-CoV. Similar to other recent coronavirus outbreaks, including SARS and MERS, SARS-CoV-2 infected patients typically present with fever, dry cough, fatigue, and lower respiratory system dysfunction, including high rates of pneumonia and acute respiratory distress syndrome (ARDS); however, a rapidly accumulating set of clinical studies revealed atypical symptoms of COVID-19 that involve neurological signs, including headaches, anosmia, nausea, dysgeusia, damage to respiratory centers, and cerebral infarction. These unexpected findings may provide important clues regarding the pathological sequela of SARS-CoV-2 infection. Moreover, no efficacious therapies or vaccines are currently available, complicating the clinical management of COVID-19 patients and emphasizing the public health need for controlled, hypothesis-driven experimental studies to provide a framework for therapeutic development. In this mini-review, we summarize the current body of literature regarding the central nervous system (CNS) effects of SARS-CoV-2 and discuss several potential targets for therapeutic development to reduce neurological consequences in COVID-19 patients.

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Section: Challenges For the Clinical Management Of Covid-19mentioning

confidence: 99%

Neurological consequences of COVID-19: what have we learned and where do we go from here?

Jarrahi

Ahluwalia

Khodadadi

et al. 2020

J Neuroinflammation

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show abstract

“…However, IFN-β is still the first-line drug in MS. Since the beginning of the COVID-19 pandemic, international guidelines have suggested to start or continue IFN-β treatment in pwMS [ 48 , 49 ]. Subsequent studies on MS patients affected by SARS-CoV-2 have suggested that, in general, DMTs should not increase the risk to develop a severe COVID-19 infection, and MS patients under IFN-β therapy are in the “no-risk” group [ 15 ].…”

Section: First-line Drugsmentioning

confidence: 99%

“…In addition, a recent study has shown that IFN-I evasion by SARS-CoV-2 involves multiple molecular mechanisms, which include ORF6 [ 50 ]. Moreover, SARS-CoV-2-related nonstructural protein 6 (nsp6) and 13 (nsp13) inhibit IFN-I signaling more efficiently than nonstructural proteins of SARS-CoV and MERS-CoV [ 49 ]. In contrast to previous findings, the same study shows that SARS-CoV-2 is resistant to IFN-I treatment [ 50 ].…”

Section: First-line Drugsmentioning

confidence: 99%

Drugs Used in the Treatment of Multiple Sclerosis During COVID-19 Pandemic: A Critical Viewpoint

Alborghetti

Bellucci

Gentile

et al. 2022

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: Since COVID-19 has emerged as a word public health problem, attention has been focused on how immune suppressive drugs used for the treatment of autoimmune disorders influence the risk for SARS-CoV-2 infection and the development of the acute respiratory distress syndrome (ARDS). Here we discuss the disease-modifying agents approved for the treatment of multiple sclerosis (MS) within this context. Interferon (IFN)-1a and -1b, which display antiviral activity, could be protective in the early stage of COVID-19 infection, although SARS-CoV-2 may have developed resistance to IFNs. However, in the hyper inflammation stage, IFNs may become detrimental by facilitating macrophage invasion in the lung and other organs. Glatiramer acetate and its analogues should not interfere with the development of COVID-19 and may be considered safe. Teriflunomide, a first-line oral drug used in the treatment of relapsing-remitting MS (RRMS) may display antiviral activity by depleting cellular nucleotides necessary for viral replication. The other first-line drug, dimethyl fumarate, may afford protection against SARS-CoV-2 by activating the Nrf-2 pathway and reinforcing the cellular defences against oxidative stress. Concern has been raised on the use of second-line treatments for MS during COVID-19 pandemic. However, this concern is not always justified. For example, fingolimod, might be highly beneficial during the hyperinflammatory stage of COVID-19 for a number of mechanisms including the reinforcement of the endothelial barrier. Caution is suggested for the use of natalizumab, cladribine, alemtuzumab, and ocrelizumab, although MS disease recurrence after discontinuation of these drugs may overcome a potential risk for COVID-19 infection.

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“…2020 has been the year of coronavirus disease 2019 (COVID-19), and all of us have been affected. The impact on Neurology ® Neuroimmunology, Neuroinflammation ( N2 ) is reflected by the many articles on a variety of COVID-19–related topics such as whether patients with MS and other neuroimmunologic diseases are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 1 – 7 ; how extending treatment dosing intervals (to reduce the risk of viral infections) affects the course of MS 8 , 9 ; and the possible effects of the virus on the peripheral and CNS. An early review by Dr. Dalakas 10 covered many of the potential complications of COVID-19 on the peripheral nervous system.…”

mentioning

confidence: 99%

“…Because of the antiviral properties of type I IFNs α and β, it has been suggested that IFN-β therapy in MS could be protective against COVID-19. 7 Whether anti-CD20 B cell–depleting antibodies pose greater risk of COVID-19 is not clear. A large study of patients with MS in Italy identified a higher risk of severe outcome of COVID-19 infection in patients with MS treated with ocrelizumab or RTX.…”

mentioning

confidence: 99%

N2 year in review

Dalmau¹,

Dalakas

Kolson

et al. 2021

Neurol Neuroimmunol Neuroinflamm

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Should interferons take front stage as an essential MS disease-modifying therapy in the era of coronavirus disease 2019?

Cited by 4 publications

References 8 publications

Neurological consequences of COVID-19: what have we learned and where do we go from here?

Neurological consequences of COVID-19: what have we learned and where do we go from here?

Drugs Used in the Treatment of Multiple Sclerosis During COVID-19 Pandemic: A Critical Viewpoint

N2 year in review

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