Abstract | BACKGROUND: OBJECTIVE: METHODS: The IBM® Explorys electronic health record database of > 72,000,000 patients from US healthcare networks identified patients with MS or SLE, with and without polymerase chain reaction-confirmed COVID-19. COVID-19 cumulative incidence, hospitalization, and deaths among DMT classes were compared using logistic regression (adjusted for age, sex, body mass index, comorbidities, and race/ethnicity). As a secondary data source to assess safety data, COVID-19 reports for Biogen MS therapies were extracted and described from Biogen's Global Safety Database. RESULTS: 30,478 PwMS with an open DMT prescription were identified within Explorys; 344 were COVID-19 positive. The most significant risk factors for acquiring COVID-19 were comorbidity score ≥ 1, body mass index ≥ 30, and Black/African ancestry. Similar risk factors were also identified for patients with SLE. Patients with MS were less likely to develop COVID-19 when treated with interferons (0.61%) and glatiramer acetate (0.51%), vs all other MS DMTs (both p < 0.001); anti-CD20 therapy was associated with the highest risk (3.45%; p < 0.0001). In the Biogen Global Safety Database, we identified 1217 patients who were COVID-19 positive treated with intramuscular interferon beta-1a, peginterferon beta-1a, natalizumab, dimethyl fumarate, diroximel fumarate, or fampridine. CONCLUSIONS: Comorbidities, obesity, and Black/African ancestry, but not age, were associated with a higher risk of SARS-CoV-2 infection in PwMS. Interferons and glatiramer acetate were associated with a reduced COVID-19 risk, whereas anti-CD20 therapies were associated with an increased risk, within the treated MS cohort. COVID-19 safety reports for patients receiving Biogen MS therapies were consistent with the Explorys database and MS literature, illustrating the replicability and power of this approach.
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Authors | Anthony T Reder, Diego Centonze, Maria L Naylor, Anjali Nagpal, Rajani Rajbhandari, Arman Altincatal, Michelle Kim, Aaron Berdofe, Maha Radhakrishnan, Eunice Jung, Alfred W Sandrock, Karen Smirnakis, Catrinel Popescu, Carl de Moor |
Journal | CNS drugs
(CNS Drugs)
Vol. 35
Issue 3
Pg. 317-330
(03 2021)
ISSN: 1179-1934 [Electronic] New Zealand |
PMID | 33743151
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Crotonates
- Hydroxybutyrates
- Immunologic Factors
- Immunosuppressive Agents
- Natalizumab
- Nitriles
- Toluidines
- teriflunomide
- Alemtuzumab
- Cladribine
- Rituximab
- Interferon-beta
- Cyclosporine
- Cyclophosphamide
- Mitoxantrone
- Dimethyl Fumarate
- Fingolimod Hydrochloride
- Mycophenolic Acid
- Azathioprine
- Methotrexate
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Topics |
- Adolescent
- Adult
- Black or African American
(statistics & numerical data)
- Aged
- Aged, 80 and over
- Alemtuzumab
(therapeutic use)
- Azathioprine
(therapeutic use)
- COVID-19
(epidemiology, mortality)
- Cladribine
(therapeutic use)
- Comorbidity
- Crotonates
(therapeutic use)
- Cyclophosphamide
(therapeutic use)
- Cyclosporine
(therapeutic use)
- Databases, Factual
- Dimethyl Fumarate
(therapeutic use)
- Female
- Fingolimod Hydrochloride
(therapeutic use)
- Hospitalization
(statistics & numerical data)
- Humans
- Hydroxybutyrates
- Immunologic Factors
(therapeutic use)
- Immunosuppressive Agents
(therapeutic use)
- Incidence
- Interferon-beta
(therapeutic use)
- Logistic Models
- Lupus Erythematosus, Systemic
(drug therapy, epidemiology)
- Male
- Methotrexate
(therapeutic use)
- Middle Aged
- Mitoxantrone
(therapeutic use)
- Multiple Sclerosis
(drug therapy, epidemiology)
- Mycophenolic Acid
(therapeutic use)
- Natalizumab
(therapeutic use)
- Nitriles
- Obesity
(epidemiology)
- Risk Factors
- Rituximab
(therapeutic use)
- SARS-CoV-2
- Toluidines
(therapeutic use)
- United States
(epidemiology)
- White People
(statistics & numerical data)
- Young Adult
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