COVID-19 Infection in Fingolimod- or Siponimod-Treated Patients: Case Series

Area of Science:

• Neurology
• Immunology
• Infectious Diseases

Background:

• Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Fingolimod and siponimod are sphingosine-1-phosphate receptor modulators used in MS treatment.
• Understanding COVID-19 impact in MS patients on these therapies is crucial.

Purpose of the Study:

• To analyze COVID-19 infection characteristics and outcomes in patients treated with fingolimod or siponimod.
• To compare the severity of COVID-19 in these patients with general and MS populations.

Main Methods:

• Descriptive analysis of COVID-19 cases reported to Novartis through December 27, 2020.
• Inclusion of data from postmarketing surveillance and ongoing clinical trials.
• Review of patient demographics, disease presentation, hospitalization, and outcomes.

Main Results:

• 283 COVID-19 cases in fingolimod users (mean age 44); 54 cases in siponimod users (mean age 54).
• Majority of cases were asymptomatic or mild; hospitalization rates were 31% for fingolimod and 17% for siponimod.
• Fatal outcomes reported in 1.4% of fingolimod cases and 5.6% of siponimod cases.

Conclusions:

• The risk of severe COVID-19 in patients on fingolimod or siponimod seems comparable to the general and MS populations.
• Limitations due to spontaneous reporting and missing data necessitate cautious interpretation.
• Further research may be needed to fully elucidate COVID-19 risks in this patient group.