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http://hdl.handle.net/1942/36075
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DC Field | Value | Language |
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dc.contributor.author | Simpson-Yap, Steve | - |
dc.contributor.author | DE BROUWER, Edward | - |
dc.contributor.author | Kalincik, Tomas | - |
dc.contributor.author | Rijke, Nick | - |
dc.contributor.author | Hillert, Jan A. | - |
dc.contributor.author | Walton, Clare | - |
dc.contributor.author | Edan, Gilles | - |
dc.contributor.author | Moreau, Yves | - |
dc.contributor.author | Spelman, Tim | - |
dc.contributor.author | GEYS, Lotte | - |
dc.contributor.author | PARCIAK, Tina | - |
dc.contributor.author | Gautrais, Clement | - |
dc.contributor.author | Lazovski, Nikola | - |
dc.contributor.author | PIRMANI, Ashkan | - |
dc.contributor.author | Ardeshirdavanai, Amin | - |
dc.contributor.author | Forsberg, Lars | - |
dc.contributor.author | Glaser, Anna | - |
dc.contributor.author | McBurney, Robert | - |
dc.contributor.author | Schmidt, Hollie | - |
dc.contributor.author | Bergmann, Arnfin B. | - |
dc.contributor.author | Braune, Stefan | - |
dc.contributor.author | Stahmann, Alexander | - |
dc.contributor.author | Middleton, Rodden | - |
dc.contributor.author | Salter, Amber | - |
dc.contributor.author | Fox, Robert J. | - |
dc.contributor.author | van der Walt, Anneke | - |
dc.contributor.author | Butzkueven, Helmut | - |
dc.contributor.author | Alroughani, Raed | - |
dc.contributor.author | Ozakbas, Serkan | - |
dc.contributor.author | Rojas, Juan, I | - |
dc.contributor.author | van der Mei, Ingrid | - |
dc.contributor.author | Nag, Nupur | - |
dc.contributor.author | Ivanov, Rumen | - |
dc.contributor.author | do Olival, Guilherme Sciascia | - |
dc.contributor.author | Dias, Alice Estavo | - |
dc.contributor.author | Magyari, Melinda | - |
dc.contributor.author | Brum, Doralina | - |
dc.contributor.author | Mendes, Maria Fernanda | - |
dc.contributor.author | Alonso, Ricardo N. | - |
dc.contributor.author | Nicholas, Richard S. | - |
dc.contributor.author | Bauer, Johana | - |
dc.contributor.author | Chertcoff, Anibal Sebastian | - |
dc.contributor.author | Zabalza, Anna | - |
dc.contributor.author | Arrambide, Georgina | - |
dc.contributor.author | Fidao, Alexander | - |
dc.contributor.author | Comi, Giancarlo | - |
dc.contributor.author | PEETERS, Liesbet | - |
dc.date.accessioned | 2021-12-07T12:33:37Z | - |
dc.date.available | 2021-12-07T12:33:37Z | - |
dc.date.issued | 2021 | - |
dc.date.submitted | 2021-12-07T09:08:52Z | - |
dc.identifier.citation | Neurology, 97 (19) , p. E1870 -E1885 | - |
dc.identifier.uri | http://hdl.handle.net/1942/36075 | - |
dc.description.abstract | Background and Objectives People with multiple sclerosis (MS) are a vulnerable group for severe coronavirus disease 2019 (COVID-19), particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS. Methods Data from 12 data sources in 28 countries were aggregated (sources could include patients from 1-12 countries). Demographic (age, sex), clinical (MS phenotype, disability), and DMT (untreated, alemtuzumab, cladribine, dimethyl fumarate, glatiramer acetate, interferon, natalizumab, ocrelizumab, rituximab, siponimod, other DMTs) covariates were queried, along with COVID-19 severity outcomes, hospitalization, intensive care unit (ICU) admission, need for artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression adjusted for age, sex, MS phenotype, and Expanded Disability Status Scale (EDSS) score. Results Six hundred fifty-seven (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analyzed. Among suspected plus confirmed and confirmed-only COVID-19, 20.9% and 26.9% were hospitalized, 5.4% and 7.2% were admitted to ICU, 4.1% and 5.4% required artificial ventilation, and 3.2% and 3.9% died. Older age, progressive MS phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl fumarate, ocrelizumab and rituximab were associated with hospitalization (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.01-2.41; aOR 2.43, 95% CI 1.48-4.02) and ICU admission (aOR 2.30, 95% CI 0.98-5.39; aOR 3.93, 95% CI 1.56-9.89), although only rituximab was associated with higher risk of artificial ventilation (aOR 4.00, 95% CI 1.54-10.39). Compared to pooled other DMTs, ocrelizumab and rituximab were associated with hospitalization (aOR 1.75, 95% CI 1.29-2.38; aOR 2.76, 95% CI 1.87-4.07) and ICU admission (aOR 2.55, 95% CI 1.49-4.36; aOR 4.32, 95% CI 2.27-8.23), but only rituximab was associated with artificial ventilation (aOR 6.15, 95% CI 3.09-12.27). Compared to natalizumab, ocrelizumab and rituximab were associated with hospitalization (aOR 1.86, 95% CI 1.13-3.07; aOR 2.88, 95% CI 1.68-4.92) and ICU admission (aOR 2.13, 95% CI 0.85-5.35; aOR 3.23, 95% CI 1.17-8.91), but only rituximab was associated with ventilation (aOR 5.52, 95% CI 1.71-17.84). Associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death. Stratification by age, MS phenotype, and EDSS score found no indications that DMT associations with COVID-19 severity reflected differential DMT allocation by underlying COVID-19 severity. Discussion Using the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab with increased risk of hospitalization, ICU admission, and need for artificial ventilation and of ocrelizumab with hospitalization and ICU admission. Despite the cross-sectional design of the study, the internal and external consistency of these results with prior studies suggests that rituximab/ocrelizumab use may be a risk factor for more severe COVID-19. | - |
dc.description.sponsorship | Multiple Sclerosis International Federation (MSIF); Multiple Sclerosis Data Alliance (MSDA); BiogenBiogen; Bristol-Myers SquibbBristol-Myers Squibb; Canopy Growth Corp.; GenzymeSanofi-AventisGenzyme Corporation; Icometrix; MerckMerck & Company; Mylan; NovartisNovartis; QMENTA; Quanterix; RocheRoche Holding; Med-Day; Flemish government under the Onderzoeksprogramma Artificiele Intelligentie Vlaanderen programme; Research Foundation Fladers (FWO)FWO; National Health and Medical Research Council (NHMRC)National Health and Medical Research Council of Australia [1129189, 1140766] | - |
dc.language.iso | en | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.rights | This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), | - |
dc.title | Associations of Disease-Modifying Therapies With COVID-19 Severity in Multiple Sclerosis | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | E1885 | - |
dc.identifier.issue | 19 | - |
dc.identifier.spage | E1870 | - |
dc.identifier.volume | 97 | - |
local.format.pages | 16 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Peeters, L (corresponding author), Hasselt Univ, Data Sci Inst, Biomed Res Inst, Hasselt, Belgium. | - |
dc.description.notes | liesbet.peeters@uhasselt.be | - |
local.publisher.place | TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1212/WNL.0000000000012753 | - |
dc.identifier.isi | WOS:000713678100016 | - |
dc.contributor.orcid | Zabalza, Ana/0000-0003-3860-5251; Simpson, Jr., | - |
dc.contributor.orcid | Steve/0000-0001-6521-3056; Kalincik, Tomas/0000-0003-3778-1376 | - |
local.provider.type | wosris | - |
local.uhasselt.uhpub | yes | - |
local.description.affiliation | [Simpson-Yap, Steve; Kalincik, Tomas; Nag, Nupur; Fidao, Alexander] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Dept Med, CORe, Parkville, Vic, Australia. | - |
local.description.affiliation | [Simpson-Yap, Steve; Kalincik, Tomas; Nag, Nupur; Fidao, Alexander] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Neuroepiderniol Unit, Parkville, Vic, Australia. | - |
local.description.affiliation | [Simpson-Yap, Steve] Univ Tasmania, Menzies Inst Med Res, Hobart, Tas, Australia. | - |
local.description.affiliation | [De Brouwer, Edward; Moreau, Yves; Pirmani, Ashkan] Katholieke Univ Leuven, ESAT STADIUS, Leuven, Belgium. | - |
local.description.affiliation | [Kalincik, Tomas] Royal Melbourne Hosp, Melbourne MS Ctr, Dept Neurol, Parkville, Vic, Australia. | - |
local.description.affiliation | [Rijke, Nick; Walton, Clare] MS Int Federat, London, England. | - |
local.description.affiliation | [Hillert, Jan A.; Spelman, Tim; Forsberg, Lars; Glaser, Anna] Swedish MS Registry, Dept Clin Neurosci, Stockholm, Sweden. | - |
local.description.affiliation | [Edan, Gilles] CHU Pontchaillou, Dept Neurol, Rennes, France. | - |
local.description.affiliation | [Spelman, Tim] Karolinska Inst, Solna, Sweden. | - |
local.description.affiliation | [Geys, Lotte; Pirmani, Ashkan; Peeters, Liesbet] Hasselt Univ, Data Sci Inst, Biomed Res Inst, Hasselt, Belgium. | - |
local.description.affiliation | [Parciak, Tina] Univ Med Ctr Gottingen, Dept Med Informat, Gottingen, Germany. | - |
local.description.affiliation | [Gautrais, Clement] Katholieke Univ Leuven, Dept Comp Sci & AI, Leuven, Belgium. | - |
local.description.affiliation | [Lazovski, Nikola] QMENTA, Barcelona, Spain. | - |
local.description.affiliation | [Ardeshirdavanai, Amin] Medpace Reference Labs, Mol Unit, Leuven, Belgium. | - |
local.description.affiliation | [McBurney, Robert; Schmidt, Hollie] Accelerated Cure Project MS, iConquerMS People Powered Res Network, Waltham, MA USA. | - |
local.description.affiliation | [Bergmann, Arnfin B.; Braune, Stefan] NeuroTransData, NeuroTransData Study Grp, Neuburg, Germany. | - |
local.description.affiliation | [Stahmann, Alexander] MS Forschungs & Projektentwicklungs gGmbH, German MS Register Natl MS Soc, Hannover, Germany. | - |
local.description.affiliation | [Middleton, Rodden; Nicholas, Richard S.] Swansea Univ, UK MS Register, Swansea, W Glam, Wales. | - |
local.description.affiliation | [Salter, Amber; Fox, Robert J.] COViMS, St Louis, MO USA. | - |
local.description.affiliation | [Salter, Amber] Washington Univ, Div Biostat, St Louis, MO USA. | - |
local.description.affiliation | [Fox, Robert J.] Cleveland Clin, Mellen Ctr Multiple Sclerosis, Cleveland, OH 44106 USA. | - |
local.description.affiliation | [van der Walt, Anneke; Butzkueven, Helmut] Monash Univ, Cent Clin Sch, Dept Neurosci, Melbourne, Vic, Australia. | - |
local.description.affiliation | [Alroughani, Raed] Al Amiri Hosp, Kuwait, Kuwait. | - |
local.description.affiliation | [Ozakbas, Serkan] Dokuz Eylul Univ, Izmir, Turkey. | - |
local.description.affiliation | [Rojas, Juan, I] Hosp Univ CEMIC, Neurol Dept, Buenos Aires, DF, Argentina. | - |
local.description.affiliation | [Rojas, Juan, I] RELACOEM, Buenos Aires, DF, Argentina. | - |
local.description.affiliation | [van der Mei, Ingrid] Univ Tasmania, Menzies Inst Med Res, Australian MS Longitudinal Study, Hobart, Tas, Australia. | - |
local.description.affiliation | [Ivanov, Rumen] Bulgarian SmartMS COVID 19 Dataset, Sofia, Bulgaria. | - |
local.description.affiliation | [do Olival, Guilherme Sciascia; Dias, Alice Estavo] ABEM Brazilian MS Patients Assoc, Sao Paulo, Brazil. | - |
local.description.affiliation | [Magyari, Melinda] Univ Hosp, Rigshosp, Dept Neurol, Danish Multiple Sclerosis Registry, Glostrup, Denmark. | - |
local.description.affiliation | [Brum, Doralina] Univ Estadual Paulista, UNESP, Fac Med, Botucatu, SP, Brazil. | - |
local.description.affiliation | [Brum, Doralina; Mendes, Maria Fernanda] REDONE br Brazilian Registry Multiple Sclerosis, Sao Paulo, Brazil. | - |
local.description.affiliation | [Mendes, Maria Fernanda] Irmandade Santa Casa Misencordia Sao Paulo, Sao Paulo, Brazil. | - |
local.description.affiliation | [Alonso, Ricardo N.] Ramos Mejia Hosp EMA, Multiple Sclerosis Univ Ctr, Buenos Aires, DF, Argentina. | - |
local.description.affiliation | [Nicholas, Richard S.] Imperial Coll London, London, England. | - |
local.description.affiliation | [Nicholas, Richard S.] Swansea Univ, Swansea, W Glam, Wales. | - |
local.description.affiliation | [Bauer, Johana] Hosp Britan Buenos Aires, EMA, Mental Hlth Area, Buenos Aires, DF, Argentina. | - |
local.description.affiliation | [Chertcoff, Anibal Sebastian] Hosp Britan Buenos Aires, EMA, MS & Demyelinating Dis, Buenos Aires, DF, Argentina. | - |
local.description.affiliation | [Zabalza, Anna; Arrambide, Georgina] Cemcat, Ctr Esclerosi Multiple Catalunya, Serv Neurol Neuroimmunol, Barcelona, Spain. | - |
local.description.affiliation | [Zabalza, Anna; Arrambide, Georgina] Vall dHebron Hosp Univ, Vall dHebron Inst Recerca, Barcelona, Spain. | - |
local.description.affiliation | [Zabalza, Anna; Arrambide, Georgina] Univ Autonoma Barcelona, Barcelona, Spain. | - |
local.description.affiliation | [Comi, Giancarlo] Osped San Raffaele, Inst Expt Neurol, Milan, Italy. | - |
local.uhasselt.international | yes | - |
item.fullcitation | Simpson-Yap, Steve; DE BROUWER, Edward; Kalincik, Tomas; Rijke, Nick; Hillert, Jan A.; Walton, Clare; Edan, Gilles; Moreau, Yves; Spelman, Tim; GEYS, Lotte; PARCIAK, Tina; Gautrais, Clement; Lazovski, Nikola; PIRMANI, Ashkan; Ardeshirdavanai, Amin; Forsberg, Lars; Glaser, Anna; McBurney, Robert; Schmidt, Hollie; Bergmann, Arnfin B.; Braune, Stefan; Stahmann, Alexander; Middleton, Rodden; Salter, Amber; Fox, Robert J.; van der Walt, Anneke; Butzkueven, Helmut; Alroughani, Raed; Ozakbas, Serkan; Rojas, Juan, I; van der Mei, Ingrid; Nag, Nupur; Ivanov, Rumen; do Olival, Guilherme Sciascia; Dias, Alice Estavo; Magyari, Melinda; Brum, Doralina; Mendes, Maria Fernanda; Alonso, Ricardo N.; Nicholas, Richard S.; Bauer, Johana; Chertcoff, Anibal Sebastian; Zabalza, Anna; Arrambide, Georgina; Fidao, Alexander; Comi, Giancarlo & PEETERS, Liesbet (2021) Associations of Disease-Modifying Therapies With COVID-19 Severity in Multiple Sclerosis. In: Neurology, 97 (19) , p. E1870 -E1885. | - |
item.validation | ecoom 2022 | - |
item.contributor | Simpson-Yap, Steve | - |
item.contributor | DE BROUWER, Edward | - |
item.contributor | Kalincik, Tomas | - |
item.contributor | Rijke, Nick | - |
item.contributor | Hillert, Jan A. | - |
item.contributor | Walton, Clare | - |
item.contributor | Edan, Gilles | - |
item.contributor | Moreau, Yves | - |
item.contributor | Spelman, Tim | - |
item.contributor | GEYS, Lotte | - |
item.contributor | PARCIAK, Tina | - |
item.contributor | Gautrais, Clement | - |
item.contributor | Lazovski, Nikola | - |
item.contributor | PIRMANI, Ashkan | - |
item.contributor | Ardeshirdavanai, Amin | - |
item.contributor | Forsberg, Lars | - |
item.contributor | Glaser, Anna | - |
item.contributor | McBurney, Robert | - |
item.contributor | Schmidt, Hollie | - |
item.contributor | Bergmann, Arnfin B. | - |
item.contributor | Braune, Stefan | - |
item.contributor | Stahmann, Alexander | - |
item.contributor | Middleton, Rodden | - |
item.contributor | Salter, Amber | - |
item.contributor | Fox, Robert J. | - |
item.contributor | van der Walt, Anneke | - |
item.contributor | Butzkueven, Helmut | - |
item.contributor | Alroughani, Raed | - |
item.contributor | Ozakbas, Serkan | - |
item.contributor | Rojas, Juan, I | - |
item.contributor | van der Mei, Ingrid | - |
item.contributor | Nag, Nupur | - |
item.contributor | Ivanov, Rumen | - |
item.contributor | do Olival, Guilherme Sciascia | - |
item.contributor | Dias, Alice Estavo | - |
item.contributor | Magyari, Melinda | - |
item.contributor | Brum, Doralina | - |
item.contributor | Mendes, Maria Fernanda | - |
item.contributor | Alonso, Ricardo N. | - |
item.contributor | Nicholas, Richard S. | - |
item.contributor | Bauer, Johana | - |
item.contributor | Chertcoff, Anibal Sebastian | - |
item.contributor | Zabalza, Anna | - |
item.contributor | Arrambide, Georgina | - |
item.contributor | Fidao, Alexander | - |
item.contributor | Comi, Giancarlo | - |
item.contributor | PEETERS, Liesbet | - |
item.fulltext | With Fulltext | - |
item.accessRights | Open Access | - |
crisitem.journal.issn | 0028-3878 | - |
crisitem.journal.eissn | 1526-632X | - |
Appears in Collections: | Research publications |
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e1870.full.pdf | Published version | 748.25 kB | Adobe PDF | View/Open |
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