Monoclonal antibody therapies for rapidly progressive and highly active multiple sclerosis in the era of the COVID-19 pandemic

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As the COVID-19 pandemic continues, reducing the risk of infection for immunocompromised patients remains an important issue. Patients with aggressive multiple sclerosis (MS) require immunosuppressive therapy in order to control the overactive autoimmune response. Preliminary international and national trials demonstrate that older age, higher disability status and progressive MS are generally associated with a more severe clinical course of COVID-19. However, uncertainty remains about the effect of disease-modifying therapies on the COVID-19 clinical presentation. In this article, we pay special attention to monoclonal antibodies used for immune reconstitution therapy, which results in significant changes to the T-cell and/or B-cell repertoire. Based on the published data from registries in different countries, we attempted to estimate the benefits and risks of these therapies in a complicated epidemiological setting.

Keywords:

highly active multiple sclerosis

immunosuppressive therapy

COVID-19

natalizumab

alemtuzumab

ocrelizumab

Authors:

Eliseeva D.D.

Research Center of Neurology

ORCID: 0000-0003-2173-927X

Vasilyev A.V.

Central Research Institute of Dentistry and Maxillofacial Surgery;
Research Centre for Medical Genetics

ORCID: 0000-0002-7169-2724

Abramova A.A.

Research Center of Neurology

Kochergin I.A.

Research Center of Neurology

Zakharova M.N.

Research Center of Neurology

SPIN RSCI: 4277-2860
Scopus AuthorID: 7006679636
ResearcherID: C-4611-2012
ORCID: 0000-0002-1072-9968

Received:

16.04.2021

Accepted:

16.04.2021

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