COVID-19 Infection in Multiple Sclerosis Patients Treated with Rituximab Compared to Natalizumab and Healthy Controls: A Real-World Multicenter Study.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Annals of Indian Academy of Neurology Pub Date : 2024-05-01 Epub Date: 2024-06-20 DOI:10.4103/aian.aian_151_24

Thomas Mathew, Surabhi Garg, Saji K John, Mal S Kimi, Naom Z Chhakchhuak, Sherina Koshy, Tenzin Yangdonq, Molly George, Shagun Bhardwaj, Yerasu M Reddy, Uday Murgod, Vikram Kamath, Sonia Shivde, Sagar Badachi, Akshata Huddar, Gosala R K Sarma, Raghunandan Nadig

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引用次数: 0

Abstract

Introduction: The impact of coronavirus disease 2019 (COVID-19) infection on patients with multiple sclerosis (MS) undergoing various immunomodulating therapies can vary. Individuals on B-cell therapy, such as rituximab, may be more susceptible to infection compared to those treated with natalizumab.

Objective: The objective of this study was to determine the incidence and severity of COVID-19 infection in patients receiving rituximab, natalizumab, and healthy controls.

Methods: This retrospective multicentric study included data derived from a centralized MS registry of four centers in South India. Data of patients on rituximab and natalizumab recruited between 2020 February and 2022 December were extracted from the registry and analyzed. The outcomes studied were the occurrence of COVID-19 infection, hospitalization, intensive care unit admission, death, post-COVID-19 relapses, and post-vaccine relapses. These outcomes were compared between the treatment groups and the matched controls.

Results: COVID-19 infection occurred in 49.1% (26/53) of those on rituximab, 19.2% (5/26) of those on natalizumab, and 11.5% (6/52) of healthy controls. In addition, 8/53 (15.1%) in the rituximab group and 1/26 (3.8%) in the natalizumab group were hospitalized. All 6/52 (11.5%) in the control group had mild infection, and none were hospitalized. No deaths occurred in any group. On statistical analysis, the occurrence of COVID-19 infection in the rituximab group was significantly higher when compared to natalizumab ( P = 0.0141) and healthy controls ( P < 0.001). Hospitalizations were significantly higher in the rituximab group when compared to healthy controls ( P < 0.006).

Conclusion: MS patients treated with rituximab were more likely to experience COVID-19 infection compared to those treated with natalizumab and healthy controls. Hospitalization was more frequently seen in patients treated with rituximab compared to healthy controls.

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利妥昔单抗治疗的多发性硬化症患者与纳他珠单抗和健康对照组的 COVID-19 感染比较：一项真实世界多中心研究。

导言：冠状病毒病2019（COVID-19）感染对接受各种免疫调节疗法的多发性硬化症（MS）患者的影响各不相同。与使用纳他珠单抗治疗的患者相比，使用利妥昔单抗等B细胞疗法的患者可能更容易受到感染：本研究旨在确定接受利妥昔单抗、纳他珠单抗治疗的患者和健康对照组中 COVID-19 感染的发生率和严重程度：这项回顾性多中心研究的数据来自南印度四个中心的多发性硬化症集中登记处。研究人员从登记册中提取并分析了 2020 年 2 月至 2022 年 12 月期间招募的利妥昔单抗和纳他珠单抗患者的数据。研究结果包括 COVID-19 感染、住院、入住重症监护室、死亡、COVID-19 后复发和疫苗后复发。这些结果在治疗组和匹配对照组之间进行了比较：使用利妥昔单抗的患者中有49.1%（26/53）感染了COVID-19，使用纳他珠单抗的患者中有19.2%（5/26）感染了COVID-19，健康对照组中有11.5%（6/52）感染了COVID-19。此外，利妥昔单抗组和纳他珠单抗组分别有 8/53 人（15.1%）和 1/26 人（3.8%）住院治疗。对照组中的 6/52（11.5%）人都有轻度感染，没有人住院治疗。各组均无死亡病例。经统计分析，利妥昔单抗组 COVID-19 感染发生率明显高于纳他珠单抗组（P = 0.0141）和健康对照组（P < 0.001）。与健康对照组相比，利妥昔单抗组的住院率明显更高（P < 0.006）：结论：与纳他珠单抗治疗组和健康对照组相比，利妥昔单抗治疗的多发性硬化症患者更容易感染 COVID-19。与健康对照组相比，接受利妥昔单抗治疗的患者更容易住院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Indian Academy of Neurology Nervous System Diseases-

CiteScore

2.20

自引率

11.80%

发文量

293

审稿时长

29 weeks

期刊介绍： The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.