Association of Disease-Modifying Therapies with COVID-19 Susceptibility and Severity in Patients with Multiple Sclerosis: A Systematic Review and Network Meta-Analysis

Background. We conducted this study to assess the effect of disease-modifying therapies (DMTs) on coronavirus disease (COVID-19) susceptibility and severity in people with multiple sclerosis (MS). Methods. Available studies from PubMed, Scopus, EMBASE, Web of Science, and gray literature, including...

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Vydáno v:Multiple sclerosis international Ročník 2022; s. 1 - 13
Hlavní autoři: Barzegar, Mahdi, Houshi, Shakiba, Sadeghi, Erfan, Hashemi, Mozhgan Sadat, Pishgahi, Ghasem, Bagherieh, Sara, Afshari-Safavi, Alireza, Mirmosayyeb, Omid, Shaygannejad, Vahid, Zabeti, Aram
Médium: Journal Article
Jazyk:angličtina
Vydáno: Egypt Hindawi 21.09.2022
John Wiley & Sons, Inc
Témata:
Analysis
Biological response modifiers
Cohort analysis
Coronaviruses
COVID-19
Development and progression
Disease susceptibility
Disease transmission
Health aspects
Hospitalization
Immunotherapy
Infections
Interferon
Medical research
Medicine, Experimental
Meta-analysis
Monoclonal antibodies
Mortality
Multiple sclerosis
Pandemics
Pharmacovigilance
Population
Review
Severe acute respiratory syndrome coronavirus 2
Software
Systematic review
Iran
United States > US
Europe
Spain
ISSN:2090-2654, 2090-2662
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Shrnutí:Background. We conducted this study to assess the effect of disease-modifying therapies (DMTs) on coronavirus disease (COVID-19) susceptibility and severity in people with multiple sclerosis (MS). Methods. Available studies from PubMed, Scopus, EMBASE, Web of Science, and gray literature, including reference lists and conference abstracts, were searched from December 1, 2019, to July 26, 2021. We included cross-sectional, case-control, and cohort studies assessing the association of DMTs with risk of contracting COVID-19 or its outcomes in MS patients on univariate or multivariate regression analyses. We conducted a network meta-analysis (NMA) to compare the risk of COVID-19 and developing severe infection across DMTs. Results. Out of the initial 3893 records and 1883 conference abstracts, a total of 10 studies were included. Pairwise comparisons showed that none of the DMTs meaningfully affect the risk of acquiring infection. There was significant total heterogeneity and inconsistency across this NMA. In comparison with no DMT, dimethyl fumarate (0.62 (0.42, 0.93)), fingolimod (0.55 (0.32, 0.94)), natalizumab (0.50 (0.31, 0.81)), and interferon (0.42 (0.22, 0.79)) were associated with a decreased risk of severe COVID-19; but, rituximab was observed to increase the risk (1.94 (1.20, 3.12)). Compared to rituximab or ocrelizumab, all DMTs were associated with a decreased risk. Pairwise comparisons showed no differences across other DMTs. Interferon and rituximab were associated with the lowest and highest risks of severe COVID-19. Conclusion. Our study showed an increased risk of severe COVID-19 in patients on rituximab and ocrelizumab. No association with COVID-19 severity across other DMTs was observed.
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Academic Editor: Francesco Patti
ISSN:2090-2654
2090-2662
DOI:10.1155/2022/9388813