Is it? isn’t it? The ocrelizumab Yo-Yo

I

In this paper the duration of use of ocrelizumab is a Coivd-19 risk factor in other papers, there is no risk. What is correct. I suspect abit of both and so if there is a risk I think we can say it is small, otherwise every study would be the same. Also we have to remember ocrelizumab is the agent approached for progressive MS and disabilty is a risk factor so this confounding variable needs to be put in the equation and make any reported risk even less. Also it is a product of its success, because clear if more people take product X it is more likely that people on product X will get more infections. If product X is working well people may be out and about and so increase the risk of infection. I predicted that MS-DMT would not be doom and gloom and happy to say that bit of immunology 101 was been more correct than not correct.

COVID‐19 in multiple sclerosis patients: susceptibility, severity risk factors and serological response Ana ZabalzaSimón Cárdenas‐RobledoPaula TaglianiGeorgina ArrambideSusana Otero‐RomeroPere Carbonell‐MirabentMarta Rodriguez‐BarrancoBreogán Rodríguez‐Acevedo… See all authors First published: 19 December 2020 https://doi.org/10.1111/ene.14690

Background and purpose

Information regarding multiple sclerosis (MS) patients with the 2019 novel coronavirus disease (COVID‐19) is scarce. The study objective was to describe the incidence and characteristics of MS patients with COVID‐19, to identify susceptibility and severity risk factors and to assess the proportion of positive severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) serologies according to disease‐modifying treatments.

Methods

This was a retrospective study of an MS cohort analysing data collected between February and May 2020. Cases were identified through an email survey and clinical visits. The relationship of demographic and MS characteristics with COVID‐19 and of the disease‐modifying treatments with SARS‐CoV‐2 serostatus were examined.

Results

Data from 48 suspected cases out of 758 valid respondents and from 45 COVID‐19 cases identified through clinical visits were collected. Incidence was 6.3%. Nineteen (20.3%) patients were hospitalized and two (2.2%) died. Multivariable models determined that age (odds ratio [OR] per 10 years 0.53, 95% confidence interval [CI] 0.34–0.85), contact with a confirmed case (OR 197.02, 95% CI 56.36–688.79), MS duration (OR per 5 years 1.41, 95% CI 1.09–1.83) and time on anti‐CD20 treatment (OR per 2 years 3.48, 95% CI 1.44–8.45) were independent factors for presenting COVID‐19 and age (OR per 10 years 2.71, 95% CI 1.13–6.53) for a severe COVID‐19. Out of the 79 (84.9%) with serological test, 45.6% generated antibodies, but only 17.6% of those on anti‐CD20 therapies. Lymphopaenia or immunoglobulin levels did not relate to COVID‐19.

Conclusions

Multiple sclerosis patients present similar incidence, risk factors and outcomes for COVID‐19 as the general population. Patients treated with an anti‐CD20 therapy for a longer period of time might be at a higher risk of COVID‐19 and less than 20% generate an antibody response. Only age was related to severity.

COI Multiple including involvement with the makers of ocrelizumab and alternative agents

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MouseDoctor

5 comments

  • If we stood back and asked the question. Does destroying part of your immune system make you more at a risk for getting severe form of COVID? Err do we really need a research paper to answer that question? Why are researchers so occupied by answering questions that can be inferred by anyone with some intelligence.

    • You would be surprised how often things don’t always work out how you expect them to. Some of us predicted that because antibody responses may cause bystander damage being on an anti-CD20 therapy may have actually protected you from severe COVID-19. The latter didn’t turn out to be the case.

  • Any extrapolations from these learnings for vaccine response? On Ocrelizumab for exactly two years & I just had my second Pfizer “jab”, had the first at 7 weeks after O-infusion.
    I read this “patients treated with an anti‐CD20 therapy for a longer period of time might be at a higher risk of COVID‐19 and less than 20% generate an antibody response” – made me wonder a bit (a wee bit of fretting too). Thanks!

  • my wife (6 OCR cycles – NEDA and EDSS 1) just got first jab of pfizer and had „common“ side effects for 2 days (tired, headache and soar
    arm). can there now be a conclusion that „some immune response had happened“? tx

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