Evidence map›Paper›PMID 35398713›Full record

SynthesisMultiple sclerosis and related disorders2022

Risk of COVID-19 infection and severe disease in MS patients on different disease-modifying therapies.

Tyler E Smith, Maya Madhavan, Daniel Gratch, Aneek Patel, Valerie Saha, Carrie Sammarco, Zoe Rimler, Guadalupe Zuniga, Dunia Gragui, Leigh Charvet and 4 more

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Multiple sclerosis and related disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
4.3field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 30 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Tyler E SmithNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016. Electronic address: Tyler.Smith@nyulangone.org.
Maya MadhavanNYU Langone Health Department of Neurology, 222 E 41(st) St, 9(th) Floor, New York City, New York, 10017.
Daniel GratchNYU Langone Health Department of Neurology, 222 E 41(st) St, 9(th) Floor, New York City, New York, 10017.
Aneek PatelNYU Langone Health Department of Neurology, 222 E 41(st) St, 9(th) Floor, New York City, New York, 10017.
Valerie SahaNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Carrie SammarcoNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Zoe RimlerNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Guadalupe ZunigaNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Dunia GraguiNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Leigh CharvetNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Gary CutterUniversity of Alabama School of Public Health Department of Biostatistics, 403B Ryals Public Health Building, 1665 University Boulevard, Birmingham AL, 35294.
Lauren KruppNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Ilya KisterNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Lana Zhovtis RyersonNYU Langone Multiple Sclerosis Care Center, 240 E 38(th) St, 13(th) Floor, New York City, New York, 10016.
Multiple Sclerosis Center Of Northeastern New York · USNYU Langone Health · USAlabama Department of Public Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe risk of SARS-CoV-2 infection and severity with disease modifying therapies (DMTs) in multiple sclerosis (MS) remains unclear, with some studies demonstrating increased risks of infection with B-cell-depleting (anti-CD20) therapies and severity, while others fail to observe an association. Most existing studies are limited by a reliance on 'numerator' data (i.e., COVID-19 cases) only.

objectiveTo assess the risks of COVID-19 by DMT, this study aimed to assess both 'numerator' (patients with SARS-CoV-2 infection) and 'denominator' data (all patients treated with DMTs of interest) to determine if any DMTs impart an increased risk of SARS-CoV-2 infection or disease severity.

methodsWe systematically reviewed charts and queried patients during clinic encounters in the NYU MS Comprehensive Care Center (MSCCC) for evidence of COVID-19 in all patients who were on the most commonly used DMTs in our clinic (sphingosine-1-phosphate receptor (S1P) modulators (fingolimod/siponimod), rituximab, ocrelizumab, fumarates (dimethyl fumarate/diroximel fumarate), and natalizumab). COVID-19 status was determined by clinical symptoms (CDC case definition) and laboratory testing where available (SARS-CoV-2 PCR, SARS-CoV-2 IgG). Multivariable analyses were conducted to determine predictors of infection and severe disease (hospitalization or death) using SARS-CoV-2 infected individuals per DMT group and all individuals on a given DMT as denominator.

resultsWe identified 1,439 MS patients on DMTs of interest, of which 230 had lab-confirmed (n = 173; 75.2%) or suspected (n = 57; 24.8%) COVID-19. Infection was most frequent in those on rituximab (35/138; 25.4%), followed by fumarates (39/217; 18.0%), S1P modulators (43/250; 17.2%), natalizumab (36/245; 14.7%), and ocrelizumab (77/589; 13.1%). There were 14 hospitalizations and 2 deaths. No DMT was found to be significantly associated with increased risk of SARS-CoV-2 infection. Rituximab was a predictor of severe SARS-CoV-2 infection among patients with SARS-CoV-2 infection (OR 6.7; 95% CI 1.1-41.7) but did not reach statistical significance when the entire patient population on DMT was used (OR 2.8; 95% CI 0.6-12.2). No other DMT was associated with an increased risk of severe COVID-19.

conclusionsAnalysis of COVID-19 risk among all patients on the commonly used DMTs did not demonstrate increased risk of infection with any DMT. Rituximab was associated with increased risk for severe disease.

Indexed as

COVID-19Multiple SclerosisDimethyl FumarateHumansNatalizumabRituximabSARS-CoV-2Dimethyl FumarateNatalizumabRituximabCOVID-19disease-modifying therapydisease severityMultiple Sclerosis

Identifiers

PMID35398713
PMCPMC8915504
OpenAlexW4220937822

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.