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. 2021 Apr;8(4):938-943.
doi: 10.1002/acn3.51342. Epub 2021 Mar 30.

Multiple sclerosis, rituximab, and COVID-19

Annette Langer-Gould  1 , Jessica B Smith  2 , Bonnie H Li  2 ; KPSC MS Specialist Group
Collaborators, Affiliations

Multiple sclerosis, rituximab, and COVID-19

Annette Langer-Gould et al. Ann Clin Transl Neurol. 2021 Apr.

Abstract

We conducted a retrospective cohort study in Kaiser Permanente Southern California from 1 January 2020 to 30 September 2020. We found that rituximab-treated persons with multiple sclerosis (pwMS, n = 1895) were more likely be hospitalized (n = 8, 33.3%), but not die (n = 0) from COVID-19, compared to the 4.81 million non-MS population (5.8% and 1.4%, respectively). Time in months (adjusted OR = 0.32, 95% CI = 0.15-0.69, p = 0.0033) and receiving 1000 mg compared to lower doses at last infusion (adjusted OR = 6.28, 95% CI = 1.38-28.5, p = 0.0173) were independent predictors of COVID-19 severity. Rituximab-treated pwMS should be counseled to take extra precautions in the 5 months following each infusion. Using extended dosing intervals and lower doses could be considered.

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Conflict of interest statement

ALG has received grant support and awards from the National Institutes of Health, Patient‐Centered Outcomes Research Institute, and the National MS Society. She currently serves as a voting member on the California Technology Assessment Forum, a core program of the Institute for Clinical and Economic Review (ICER). She has received sponsored and reimbursed travel from ICER. JBS and BHL have nothing to report.

Figures

Figure 1
Figure 1
The Relationship between COVID‐19 Severity and Most Recent Rituximab Treatment for Multiple Sclerosis. Depicted is the proportion of COVID‐19 MS patients who required hospitalization (orange) and those COVID‐19 patients who did not (blue) in the months (mos.) following their most recent rituximab infusion. The sample sizes (N) are denoted above each bar. The risk of a moderate course appears highest in the first 2 months following rituximab infusion and dissipates by 6 months.
See this image and copyright information in PMC

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