#MSCOVID19. Natalizumab case report

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The new norm will be, the post-covid19 norm I suspect will be extended interval dosing. And we will get real life PML data, it will be Pre-COVID and Post-COVID I predict a presentaion for ECTRIMS 2020 or more likely AAN2021

Borriello & Ianniell. Natalizumab treatment: a case report in a patient with extended interval dosing approach. Published:April 30, 2020DOI:https://doi.org/10.1016/j.msard.2020.10216

Background: The novel Coronavirus SARS-CoV-2, which was identified after a recent outbreak in Wuhan, China, in December 2019, has generated a global pandemic impacting over 200 countries around the world. Recent reports suggest that ACE2, which is the target protein to invade the host, has a ubiquitous presence in human organs, including lung parenchyma, gastrointestinal tract, nasal mucosa, renal and urinary tract, airway epithelia, lymphoid tissues, reproductive organs, vascular endothelium and neurons. In this scenario, neurologists are particularly involved into considering even more specific therapeutic strategies according to the available data during the pandemic. In particular, MS patients are usually receiving disease-modifying therapies (DMTs) with immunosuppressant or immunomodulatory effects, which increase the risk of infections and morbidity, compared with the general population. Development of PML or other serious opportunistic infections during treatment with natalizumab forces to consider whether de-risking strategies are needed in this particular context and how to manage a high-efficacy treatment.

Methods In this paper we report on a patient treated with natalizumab for relapsing MS who developed COVID-19 and recovered in a few days without complications.

Results After recovery natalizumab has been administered in the window of the extended interval dosing (EID), without reporting any worsening or new symptoms.

Discussion This case supports the opportunity to avoid discontinuing or delaying the retreatment over 8 weeks in patients recovered from a recent COVID-19.

COI Multiple non relevant

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MouseDoctor

4 comments

  • This is just a case, in our Centre unfortunally we reported of a COVID positive MS patient under natalizumab treatment who was admitted in the ICU for a very severe form.
    We need big data.

    • Marco, as you will understand, the point in this case was if we can consider a safe option to retreat with Natalizumab a patient after recovery from Covid, NOT if Tysabri patients may experience a mild form of Covid. Obviously a severe pneumonia with prolonged hospitalization makes it impossible to re-dosing in the EID approach

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