key: cord-1010279-xy6cjpel
authors: Brownlee, Wallace J
title: COVID-19 and high-efficacy multiple sclerosis therapies: Time for business as usual?
date: 2020-08-07
journal: Mult Scler
DOI: 10.1177/1352458520948211
sha: 74b84d05415015bfe85c8a340b3f1e58b6c17a39
doc_id: 1010279
cord_uid: xy6cjpel

nan

In this issue of Multiple Sclerosis Journal, two patients are reported who received treatment with Cladribine 2 or Rituximab 3 during the escalating COVID-19 pandemic in Europe. Both patients were hospitalized within a month of treatment with confirmed COVID-19 infection. Remarkably, despite severe lymphopenia due to recent Cladribine or undetectable B-lymphocyte counts from long-term Rituximab therapy, both patients only developed moderate COVID-19 pneumonia with good recovery. These new cases add to an increasing number of reports of favourable outcomes in MS patients receiving high-efficacy, lymphocyte-depleting therapies who have developed COVID-19 infection. 4, 5 In the vast majority of people with MS, COVID-19 produces a mild illness. 6 Preliminary data suggest that older age, comorbidities and more advanced physical disability are more strongly associated with poor outcomes in people with MS with COVID-19 than disease-modifying therapy use. 6 With falling rates of new COVID-19 infections in most countries, and reassuring reports of mild COVID-19 infection even in our most immunosuppressed patients, are we now ready for business as usual when treating MS? The answer is probably yes, and in many otherwise healthy, young adults with MS, the risks of disability worsening from delayed initiation or re-treatment with a high-efficacy treatment (or opting for a less effective treatment) will outweigh the potential risks of severe COVID-19 infection.

The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: Dr W.J.B. has received honoraria for educational activities and/or participated in advisory boards for Biogen, Celgene, Merck, Mylan, Novartis, Roche and Sanofi.

The author(s) received no financial support for the research, authorship and/or publication of this article.

Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic

COVID-19 pneumonia in a multiple sclerosis patient with severe lymphopenia due to recent cladribine treatment

Recovery from COVID-19 in a B cell-depleted multiple sclerosis patient

COVID-19 in 7 multiple sclerosis patients in treatment with ANTI-CD20 therapies

Alemtuzumab in multiple sclerosis during the COVID-19 pandemic: A mild uncomplicated infection despite intense immunosuppression

An Italian programme for COVID-19 infection in multiple sclerosis