COVID-19 in Argentine teriflunomide-treated multiple sclerosis patients: first national case series.

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.

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Breast Carcinoma After Ocrelizumab Therapy in Multiple Sclerosis Patients: A Case Series and Literature Review

Journal of Central Nervous System Disease ◽

10.1177/11795735211037785 ◽

2021 ◽

Vol 13 ◽

pp. 117957352110377

Author(s):

Andrew Kelsey ◽

Gabriella Casinelli ◽

Medha Tandon ◽

Shitiz Sriwastava

Keyword(s):

Breast Cancer ◽

Multiple Sclerosis ◽

Breast Carcinoma ◽

Literature Review ◽

Case Reports ◽

Case Series ◽

Progressive Multiple Sclerosis ◽

Primary Progressive Multiple Sclerosis ◽

History Of ◽

Multiple Sclerosis Patients

Ocrelizumab is a humanized CD20 monoclonal antibody which was approved for management of Relapsing Remitting Multiple Sclerosis (RRMS) and Primary Progressive Multiple Sclerosis (PPMS) in 2017. We present 2 patients, a 67-year-old woman with history of PPMS and a 42-year-old woman with RRMS, who were started on ocrelizumab and were diagnosed with invasive ductal cell breast carcinoma after 2 years of ocrelizumab infusion followed by discontinuation of the drug. Large trials conducted for ocrelizumab showed malignancies in a total of 4 cases with RRMS in OPERA 1 trial conducted over 2 years from 2011 to 2013 (breast cancer, renal cell carcinoma, and melanomas) and in 11 cases with PPMS seen in ORATORIO trial conducted in 2017. There are currently no other published case reports of breast cancer in setting of ocrelizumab use for MS outside of large trials on literature review.

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Prevalence of epilepsy in a case series of multiple sclerosis patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2010000500011 ◽

2010 ◽

Vol 68 (5) ◽

pp. 731-736 ◽

Cited By ~ 6

Author(s):

Cynthia Dumas Viveiros ◽

Regina Maria Papais Alvarenga

Keyword(s):

Multiple Sclerosis ◽

Hippocampal Sclerosis ◽

Case Series ◽

Chronic Phase ◽

Epileptic Seizures ◽

The Other ◽

Resonance Imaging ◽

Partial Seizures ◽

Complex Partial Seizures ◽

Multiple Sclerosis Patients

OBJECTIVE: The prevalence of epilepsy in multiple sclerosis (MS) patients has been a subject of interest for some years. The objectives of this study were to describe the clinical, radiological and electroencephalographic characteristics of epileptic seizures and to calculate the prevalence of epilepsy in a case series of MS patients. METHOD: Medical charts of MS patients were reviewed and patients who had suffered epileptic seizures were identified. RESULTS: Of 160 cases analyzed, 5 had suffered epileptic seizures and one had comorbid mesial hippocampal sclerosis, confirmed by magnetic resonance imaging in a patient with complex partial seizures that began fifteen years prior to her diagnosis of MS. In the other four patients, seizures occurred both during the acute phase of the disease and in the chronic phase. CONCLUSION: The prevalence of epileptic seizures in MS patients in this study was 2.5%, similar to that found in other studies.

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314 CASE SERIES OF MULTIPLE SCLEROSIS PATIENTS WITH NEUROPATHIC PAIN IMPROVED WITH THE ORAL CANNABINOID NABILONE

European Journal of Pain ◽

10.1016/j.ejpain.2007.03.329 ◽

2007 ◽

Vol 11 (S1) ◽

pp. S139-S139 ◽

Cited By ~ 1

Author(s):

W.A. Wine ◽

G.D. Ko ◽

E.J. Tumarkin

Keyword(s):

Multiple Sclerosis ◽

Neuropathic Pain ◽

Case Series ◽

Multiple Sclerosis Patients

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Natalizumab administration in multiple sclerosis patients during active SARS-CoV-2 infection: a case series

BMC Neurology ◽

10.1186/s12883-021-02421-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Clara G. Chisari ◽

Simona Toscano ◽

Sebastiano Arena ◽

Chiara Finocchiaro ◽

Arturo Montineri ◽

...

Keyword(s):

Multiple Sclerosis ◽

Intensive Care ◽

Severe Acute Respiratory Syndrome ◽

Clinical Outcome ◽

Clinical Course ◽

Case Series ◽

Neurological Complications ◽

High Potency ◽

Highly Active ◽

Multiple Sclerosis Patients

Abstract Background The Coronavirus disease 2019 (COVID-19) caused by the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a pandemic, affecting the therapeutic management for Multiple Sclerosis (MS). Any decision regarding the discontinuation of high-potency agents for moderate and highly active MS should be carefully evaluated, taking into account the potential risk of rebound of the disease. In particular, no data about clinical outcome of patients with MS receiving Natalizumab (NTZ) during active COVID-19 infection have been reported yet. Cases presentation We reported on 6 patients treated with NTZ for relapsing MS during active COVID-19 infection, who recovered without reporting any worsening or new symptoms. Most of the patients were asymptomatic, with the exception of one patient who had a slight worst COVID-19 clinical course. No patients received O2-therapy or required intensive care. No neurological complications were observed. Conclusions This paper reported the clinical outcome of patients with MS receiving NTZ during active COVID-19 infection. This case series suggests that treatment with NTZ during pandemic is relatively safe and might be continued in selected patients who are infected by COVID-19, thereby reducing the risk of MS disease rebound.

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Case Report: Covid-19 in Multiple Sclerosis Patients Treated With Ocrelizumab: A Case Series

Frontiers in Neurology ◽

10.3389/fneur.2021.691616 ◽

2021 ◽

Vol 12 ◽

Author(s):

Stefania F. De Mercanti ◽

Marco Vercellino ◽

Chiara Bosa ◽

Anastasia Alteno ◽

Valentina Schillaci ◽

...

Keyword(s):

Multiple Sclerosis ◽

Serological Test ◽

Severe Disease ◽

Case Series ◽

Case Fatality ◽

University Hospitals ◽

Real World Data ◽

Large Variability ◽

Multiple Sclerosis Patients ◽

The Impact

Introduction: Limited data are available on the course of Coronavirus disease 2019 (COVID-19) in people with Multiple Sclerosis (MS). More real-world data are needed to help the MS community to manage MS treatment properly. In particular, it is important to understand the impact of immunosuppressive therapies used to treat MS on the outcome of COVID-19.Methods: We retrospectively collected data on all confirmed cases of COVID-19 in MS patients treated with ocrelizumab, followed in two MS Centers based in University Hospitals in Northern Italy from February 2020 to June 2021.Results: We identified 15 MS patients treated with ocrelizumab with confirmed COVID-19 (mean age, 50.47 ± 9.1 years; median EDSS, 3.0; range 1.0–7.0). Of these, 14 were confirmed by nasal swab and 1 was confirmed by a serological test. COVID-19 severity was mild to moderate in the majority of patients (n = 11, 73.3%; mean age, 49.73; median EDSS 3.0). Four patients (26.7%; mean age, 52.5 years; median EDSS, 6) had severe disease and were hospitalized; one of them died (age 50, EDSS 6.0, no other comorbidities). None of them had underlying respiratory comorbidities.Conclusion: This case series highlights the large variability of the course of COVID-19 in ocrelizumab-treated MS patients. The challenges encountered by the healthcare system in the early phase of the COVID-19 pandemic might have contributed to the case fatality ratio observed in this series. Higher MS-related disability was associated with a more severe COVID-19 course.

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