Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Apr 15;14(2):368-377.
doi: 10.3390/neurolint14020030.

Multiple Sclerosis Treatment in the COVID-19 Era: A Risk-Benefit Approach

Paolo Immovilli  1 , Nicola Morelli  1   2 , Chiara Terracciano  1 , Eugenia Rota  3 , Elena Marchesi  1 , Stefano Vollaro  1 , Paola De Mitri  1 , Domenica Zaino  1 , Veronica Bazzurri  1 , Donata Guidetti  1
Affiliations
Review

Multiple Sclerosis Treatment in the COVID-19 Era: A Risk-Benefit Approach

Paolo Immovilli et al. Neurol Int. .

Abstract

The COVID-19 pandemic poses an ongoing global challenge, and several risk factors make people with multiple sclerosis (pwMS) particularly susceptible to running a severe disease course. Although the literature does report numerous articles on the risk factors for severe COVID-19 and vaccination response in pwMS, there is a scarcity of reviews integrating both these aspects into strategies aimed at minimizing risks. The aim of this review is to describe the risk of vulnerable pwMS exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the issues related to the SARS-CoV-2 vaccine and to evidence possible future strategies in the clinical management of pwMS. The authors searched for papers on severe COVID-19 risk factors, SARS-CoV-2 vaccination and people with multiple sclerosis in support of this narrative literature review. We propose a multilevel strategy aimed at: the evaluation of risk factors for severe COVID-19 in people with multiple sclerosis, identifying the most appropriate vaccination schedule that is safe for people on disease-modifying drugs (DMDs) and a strict follow-up of high-risk people with multiple sclerosis to allow for the prompt administration of monoclonal antibodies to manage COVID-19 risks in this patient population.

Keywords: COVID-19; DMD; MS therapy-related risks; S1P-modulators; SARS-CoV-2; anti-CD20; fingolimod; multiple sclerosis; ocrelizumab; vaccination.

PubMed Disclaimer

Conflict of interest statement

Paolo Immovilli received Honoraria for advising or speaking from Roche, Biogen, Merck, Sanofi Genzime, Teva and Novartis. Stefano Vollaro received Honoraria for advising or speaking from Novartis, Roche and Merck. Veronica Bazzurri received expense reimbursements for travel from Sanofy Genzime, Biogen and Roche. The other authors declare no conflicts of interest.

References

    1. Trapp B.D., Peterson J., Ransohoff R.M., Rudick R., Mörk S., Bö L. Axonal Transection in the Lesions of Multiple Sclerosis. NEJM. 1998;338:278–285. doi: 10.1056/NEJM199801293380502. - DOI - PubMed
    1. Ramagopalan S.V., Sadovnick A.D. Epidemiology of multiple sclerosis. Neurol. Clin. 2011;29:207–217. doi: 10.1016/j.ncl.2010.12.010. - DOI - PubMed
    1. Noseworthy J.H., Lucchinetti C., Rodriguez M., Weinshenker B.G. Multiple sclerosis. NEJM. 2000;343:938–952. doi: 10.1056/NEJM200009283431307. - DOI - PubMed
    1. Bivona G., Gambino C.M., Lo Sasso B., Scazzone C., Giglio R.V., Agnello L., Ciaccio M. Serum Vitamin D as a Biomarker in Autoimmune, Psychiatric and Neurodegenerative Diseases. Diagnostics. 2022;12:130. doi: 10.3390/diagnostics12010130. - DOI - PMC - PubMed
    1. Torok N., Tanaka M., Vecsei L. Searching for Peripheral Biomarkers in Neurodegenerative Diseases: The Tryptophan-Kynurenine Metabolic Pathway. Int. J. Mol. Sci. 2020;21:9338. doi: 10.3390/ijms21249338. - DOI - PMC - PubMed

LinkOut - more resources