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MS and COVID-19 challenge: asymptomatic COVID-19 infection during treatment with cladribine

Meral Seferoğlu1, Özlem Ethemoğlu2, Ömer Faruk Turan3

  • 1Department of Neurology, Bursa Yüksek İhtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey. meralbozseferoglu@gmail.com.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|June 24, 2021
PubMed
Abstract

Insights

Disease-modifying therapies (DMTs) for multiple sclerosis (MS) may lead to asymptomatic COVID-19 infections. Patients on cladribine therapy developed immunity, suggesting DMTs could be a treatment option during the pandemic.

Area of Science:

  • Immunology
  • Neurology
  • Infectious Diseases

Background:

  • Disease-modifying therapies (DMTs) for multiple sclerosis (MS) can impact immune responses due to their immunomodulatory and immunosuppressive properties.
  • The effects of DMTs on COVID-19 infection outcomes and subsequent immunity development in people with MS (pwMS) remain largely unknown.

Purpose of the Study:

  • To investigate the COVID-19 infection outcomes in patients with MS initiating cladribine therapy.
  • To assess the development of anti-SARS-CoV-2 antibody response in these patients.

Main Methods:

  • Case report of two patients with relapsing-remitting MS (RRMS) who developed COVID-19 shortly after starting cladribine.
  • Monitoring for SARS-CoV-2 infection and antibody response.

Main Results:

  • Both patients experienced asymptomatic COVID-19 infections.
  • Both patients developed a detectable anti-SARS-CoV-2 antibody response.

Conclusions:

  • Newly initiated cladribine therapy in MS patients may be associated with asymptomatic COVID-19 and subsequent immunity development.
  • Immunosuppressive DMTs like cladribine might be considered for managing highly active MS during the COVID-19 pandemic.
Keywords:
COVID-19CladribineMultiple sclerosisSARS-CoV-2 antibody response

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