The following article is part of conference coverage from the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from the AAN 2021 Virtual Annual Meeting.
Treatment with interferon may reduce the risk for COVID-19 in patients with multiple sclerosis (MS), whereas treatment with anti-CD20 therapies may increase this risk, according to research presented at the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting, held from April 17 to 22.
Researchers of the current study previously presented data, collected from March 2020, from patients with MS with suspected or confirmed COVID-19. After an increase in routine serologic testing, data were also collected asymptomatic patients with MS and COVID-19.
The current retrospective, multicenter, observational study included 902 patients with MS, including 298 (33%) with confirmed COVID-19 and 604 (67%) with suspected COVID-19. Approximately 4% (n=37) of patients were asymptomatic, which was classified as level 1 disease. The other 3 levels defining COVID-19 in this study included level 2, represented by the presence of symptoms without signs of pneumonia; level 3, which included radiologically defined pneumonia or hospitalization; and level 4, defined as intensive care unit (ICU) admission or death.
A total of 8 of 95 patients who received anti-CD20 therapies experienced ICU admission or death. Approximately 5% (n=37) of patients with MS who received treatment other than with anti-CD20 therapies and interferon were also either admitted to the ICU or died. Among the 37 asymptomatic patients, 7 (8.3%) received treatment with interferon, 1 (1.1%) with anti-CD20, and 29 (4%) with other drugs.
In the multivariable analysis, independent risk factors for severe COVID-19 included age (odds ratio [OR], 1.05; P <.001), Expanded Disability Status Scale (OR, 1.13; P =.02), and male sex (OR, 1.44; P =.057). Treatment with anti-CD20, including ocrelizumab or rituximab, was also associated with an increased risk for severe COVID-19 (OR, 1.99; P =.035). However, treatment with interferon was associated with a reduced risk for severe COVID-19 (OR, 0.48; P =.05) compared with treatment with dimethyl fumarate, a reference disease-modifying therapy.
Researchers concluded, “Data on asymptomatic patients are rapidly accumulating and will provide useful information about this specific subgroup of [patients].”
Sormani MP, Rossi ND, Schiavetti I, et al. Different disease modifying therapies can increase or decrease Covid-19 severity in multiple sclerosis. AAN 2021 Virtual Annual Meeting; April 17-22, 2021. Abstract S28.002.