Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives |
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Authors: | Vikram Bhise Suhayl Dhib-Jalbut |
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Affiliation: | 1.Departments of Pediatrics, Rutgers Robert Wood Johnson Medical School, 89 French Street, Suite 2200, New Brunswick, NJ 08901 USA ;2.Department of Neurology, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 65000, New Brunswick, NJ 08901 USA |
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Abstract: | Coronavirus SARS-CoV2 has emerged as one of the greatest infectious disease health challenges in a century. Patients with multiple sclerosis (MS) have a particular vulnerability to infections through their use of immunosuppressive disease-modifying therapies (DMTs). Specific DMTs pose particular risk based on their mechanisms of action (MOA). As a result, patients require individualized approaches to starting new treatments and continuation of therapy. Additionally, vaccinations must be considered carefully, and individuals on long-term B cell–depleting therapies may have diminished immune responses to vaccination, based on preserved T cells and diminished but present antibody titers to influenza vaccines. We review the immunology behind these treatments and their impact on COVID-19, as well as the current recommendations for best practices for use of DMTs in patients with MS.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13311-021-01008-7.Key Words: Multiple sclerosis, SARS-CoV2, disease-modifying therapy, vaccination, COVID-19, immunology |
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