Steve Simpson-Yap, Ashkan Pirmani, Tomas Kalincik, Edward De Brouwer, Lotte Geys, Tina Parciak, Anne Helme, Nick Rijke, Jan A Hillert, Yves Moreau, Gilles Edan, Sifat Sharmin, Tim Spelman, Robert McBurney, Hollie Schmidt, Arnfin B Bergmann, Stefan Braune, Alexander Stahmann, Rod M Middleton, Amber Salter, Bruce Bebo, Anneke Van der Walt, Helmut Butzkueven, Serkan Ozakbas, Cavit Boz, Rana Karabudak, Raed Alroughani, Juan I Rojas, Ingrid A van der Mei, Guilherme Sciascia do Olival, Melinda Magyari, Ricardo N Alonso, Richard S Nicholas, Anibal S Chertcoff, Ana Zabalza de Torres, Georgina Arrambide, Nupur Nag, Annabel Descamps, Lars Costers, Ruth Dobson, Aleisha Miller, Paulo Rodrigues, Vesna Prčkovska, Giancarlo Comi, Liesbet M Peeters
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Comprehensive exploration of these relationships in large international samples is needed.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>Analyzing 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.</p>","PeriodicalId":520720,"journal":{"name":"Neurology(R) neuroimmunology & neuroinflammation","volume":" ","pages":""},"PeriodicalIF":7.5000,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/15/NXI-2022-200027.PMC9423711.pdf","citationCount":"9","resultStr":"{\"title\":\"Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity.\",\"authors\":\"Steve Simpson-Yap, Ashkan Pirmani, Tomas Kalincik, Edward De Brouwer, Lotte Geys, Tina Parciak, Anne Helme, Nick Rijke, Jan A Hillert, Yves Moreau, Gilles Edan, Sifat Sharmin, Tim Spelman, Robert McBurney, Hollie Schmidt, Arnfin B Bergmann, Stefan Braune, Alexander Stahmann, Rod M Middleton, Amber Salter, Bruce Bebo, Anneke Van der Walt, Helmut Butzkueven, Serkan Ozakbas, Cavit Boz, Rana Karabudak, Raed Alroughani, Juan I Rojas, Ingrid A van der Mei, Guilherme Sciascia do Olival, Melinda Magyari, Ricardo N Alonso, Richard S Nicholas, Anibal S Chertcoff, Ana Zabalza de Torres, Georgina Arrambide, Nupur Nag, Annabel Descamps, Lars Costers, Ruth Dobson, Aleisha Miller, Paulo Rodrigues, Vesna Prčkovska, Giancarlo Comi, Liesbet M Peeters\",\"doi\":\"10.1212/NXI.0000000000200021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>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). 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引用次数: 9
摘要
背景和目的:某些人口统计学和临床特征，包括一些疾病改善疗法(dmt)的使用，与多发性硬化症(MS)患者的严重急性呼吸综合征冠状病毒2感染严重程度有关。需要在大型国际样本中对这些关系进行全面探索。方法:将来自27个国家的临床报告的人口统计学/临床数据汇总为5,648例疑似/确诊冠状病毒病2019 (COVID-19)患者的数据集。采用多水平混合效应有序probit和logistic回归评估COVID-19严重程度结局(住院、入住重症监护病房(ICU)、需要人工通气和死亡)，并根据年龄、性别、残疾和MS表型进行调整。分别将dmt与醋酸格拉替雷默、抗cd20 dmt与合并其他dmt和那他珠单抗进行比较。结果:5648例患者中，疑似病例922例(16.6%)，确诊病例4646例(83.4%)。男性、年龄较大、进展性MS和更高的残疾与更严重的COVID-19相关。与醋酸格拉替默相比，奥克雷单抗和利妥昔单抗与更高的住院概率(4% [95% CI 1-7]和7% [95% CI 4-11])、ICU/人工通气(2% [95% CI 0-4]和4% [95% CI 2-6])和死亡(1% [95% CI 0-2]和2% [95% CI 1-4])(预测的边际效应)相关。与醋酸格拉替默相比，未经治疗的患者出现COVID-19严重程度的概率分别高出5% (95% CI 2-8)、3% (95% CI 1-5)和1% (95% CI 0-3)。与合并的其他dmt和natalizumab相比，ocrelizumab和rituximab与COVID-19严重程度的相关性也更为明显。在对确诊COVID-19的限制下，所有关联都持续存在/增强。讨论:分析国际上最大的MS疑似/确诊COVID-19患者的真实数据集，证实使用抗cd20药物(ocrelizumab和rituximab)，以及男性、年龄较大、进展性MS和更高的残疾程度与更严重的COVID-19病程相关。
Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity.
Background and objectives: 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.
Discussion: Analyzing 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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