Abstract Details

Title Different disease modifying therapies can increase or decrease Covid-19 severity in Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S28 - Clinical Decision Making in MS (2:08 PM-2:16 PM)

Poster/Presentation
Number 002

Background

We previously presented data from a nationwide study of persons with MS with suspected or confirmed Covid-19, collected from March 2020. In June we started collecting also asymptomatic patients, when serological tests started to be routinely done.

Objective To describe the effect of disease modifying therapies (DMT) on Covid-19 severity in a large cohort of Italian patients with Covid-19 and multiple sclerosis (MS).

Design/Methods

This was a retrospective multi-center observational study. We defined Covid-19 severity as a 4-level variable: level1=asymptomatic, level2=symptomatic without signs of pneumonia, level3=radiologically defined pneumonia or hospitalization, level4=intensive care unit (ICU) or death. We analysed the impact of baseline variables on this outcome by a multivariable ordinal logistic model quantifying the association by Odds Ratio (OR).

Results On October 12, we enrolled 902 MS patients, 298 (33%) with confirmed and 604 (67%) with suspected Covid-19; 37 (4%) were asymptomatic. The number of ICU/deaths were 8/95 (8%) among those treated with anti-CD20 therapies (mean age=41 years), 0/84 (0%) among those treated with Interferon (mean age=47 years) and 37/723 (5%) among those treated with other drugs (mean age=43 years). Among the 37 asymptomatic patients, 7/84 (8.3%) were in Interferon, 1/95 (1.1%) was on anti-CD20 and 29/723 (4%) were on other drugs. At multivariable analysis, independent risk factors for a severe Covid-19 were age (OR=1.05,p<0.001), EDSS(OR=1.13,p=0.02), Male sex(OR=1.44,p=0.057) and DMT used: treatment with anti-CD20 (Ocrelizumab or Rituximab) increased the risk (OR=1.99,p=0.035) and treatment with Interferon reduced the risk (OR=0.48, p=0.05) of severe Covid-19 as compared to treatment with DMF, used as the reference DMT.

Conclusions

This analysis confirms on a larger population the increase of risk of severe Covid-19 of anti-CD20 therapies and highlights the protective role of Interferon. Data on asymptomatic patients are rapidly accumulating and will provide useful information about this specific subgroup of subjects.

Authors/Disclosures
Maria Pia Sormani (University of Genoa) PRESENTER	Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Geneuro. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunic. Maria Pia Sormani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medday. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Maria Pia Sormani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche.
Nicola De Rossi	Nicola De Rossi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Nicola De Rossi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for novartis. Nicola De Rossi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen.
	No disclosure on file
	No disclosure on file
Cinzia Cordioli, MD (Centro Sclerosi Multipla Spedali Civili di Br)	Dr. Cordioli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Almirall. Dr. Cordioli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Cordioli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis.
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele)	Dr. Moiola has nothing to disclose.
Marta Radaelli (Hsr)	Marta Radaelli has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono. Marta Radaelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Marta Radaelli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Marta Radaelli has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi-Genzyme.
Paolo Immovilli, MD (AUSL Piacenza, Guglielmo da Saliceto Hospital)	Dr. Immovilli has received personal compensation in the range of $0-$499 for serving as a Consultant for biogen. Dr. Immovilli has received personal compensation in the range of $0-$499 for serving as a Consultant for roche. Dr. Immovilli has received personal compensation in the range of $0-$499 for serving as a Consultant for merck.
Marco Alfonso Narduc Capobianco	Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Marco Alfonso Narduc Capobianco has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.
Maria Trojano (Policlinico - Bari)	Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi_Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen.
Paola Zaratin, PhD (Italian Foundation of Multiple Sclerosis)	Dr. Zaratin has received personal compensation for serving as an employee of FONDAZIONE ITALIANA SCLEROSI MULTIPLA.
Gioacchino Tedeschi, MD (University of Campania "L. Vanvitelli")	Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis.
	No disclosure on file
	No disclosure on file
Francesco Patti, MD	Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Almirall. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Almirall, Bayer, Biogen, Bristol Meyers and Squibb Merck, Roche, Sanofi, TEVA. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for University of Catania and AISM/FISM, Fondazione Italiana Sclerosi Multipla. Dr. Patti has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology.
Marco Salvetti, MD	Dr. Salvetti has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for sanofi. Dr. Salvetti has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for biogen. The institution of Dr. Salvetti has received research support from bms.

��ɫ��

��ɫ��