Search

Background: There is a lack information regarding risk factors associated with worse COVID-19 outcomes in patients with multiple sclerosis (MS) in the MENA region., Methods: This is a multicenter, retrospective cohort study that included all MS patients with a suspected or confirmed COVID-19 infection using the MENACTRIMS registry. The association of demographics, disease characteristics, and use of disease-modifying therapies (DMTs) with outcomes and severity of COVID-19 were evaluated by multivariate logistic model., Results: A total of 600 MS patients with confirmed (n = 542) or highly suspected (n = 58) COVID-19 were analyzed. Seventy-three patients (12.2 %) had a COVID-19 severity score of ≥3 on a 7-point ordinal scale (ranging from 1 [not hospitalized with no limitations on activities] to 7 [death] with a cutoff at 3 [hospitalized and not requiring supplemental oxygen]), and 15 patients (2.5 %) died. Out of 73 patients with a severity score ≥3, 90.4 % were on DMTs; 50.6 % of them were on anti-CD20, including ocrelizumab and rituximab. Multivariate logistic regression showed that older age (odds ratio per 10 years, 1.4 [95 %CI, 1.0-1.8]), disability (OR for EDSS 3.0-5.5, 2.9 [95 %CI. 1.5-5.7], OR for EDSS ≥6.0, 2.3 [95 %CI. 1.0-5.1]), obesity (OR, 3.0 [95 %CI, 1.5-6.0]), and treatment with rituximab (OR, 9.0 [95 %CI, 3.1-25.3]) or off-label immunosuppressive medications (OR, 5.6 [95 %CI. 1.1-27.8]) were risk factors for moderate or severe COVID-19., Conclusion: In this registry-based study of MS patients, age, sex, EDSS, obesity, progressive MS were risk factors for severe COVID-19. Moreover, there was an association found between exposure to anti-CD20 DMTs and COVID-19 severity., Competing Interests: Declaration of competing interest No conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

The newly constituted National Multiple Sclerosis (MS) Society (NMSS)of the United Arab Emirates (UAE), set up a scientific committee to create a MS disease modifying treatment (DMT) guideline for UAE. The committee considered several unique features of the MS community in UAE including large number of expatriate population, wide variations in health insurance coverage, physician and patient preferences for DMT. The overall goal of the treatment guideline is to facilitate the most appropriate DMT to the widest number of patients. To this end it has adapted recommendations from various health systems and regulatory authorities into a pragmatic amalgamation of best practices from across the world. Importantly where data is unavailable or controversial, a common sense approach is taken rather than leave physicians and patients in limbo. The committee classifies MS into subcategories and suggests appropriate treatment choices. It recommends treatment of RIS and CIS with poor prognostic factors. It largely equates the efficacy and safety of DMT with similar mechanisms of action or drug classes e.g. ocrelizumab is similar to rituximab. It allows early switching of treatment for unambiguous disease activity and those with progression independent of relapses. Autologous hematopoietic stem cell transplantation can be offered to patients who fail one high efficacy DMT. Pragmatic guidance on switching and stopping DMT, DMT choices in pregnancy, lactation and pediatric MS have been included. It is expected that these guidelines will be updated periodically as new data becomes available., Competing Interests: Declaration of competing interest Anu Jacob has received advisory board fees and speakers fee from Astra Zeneca. Ahmed Shatila has received speaker's honoraria, advisory board fees, travel grants from Novartis, Sanofi Genzyme, Roche, Merck, Jansen, Biologix, pfizer, Boehringer Ingelheim, AstraZeneca, Lundbeck and Argenx, Bayer, Biogen and received research grants from Novartis, AstraZeneca and Argenx. Jihad Inshasi has received speaker's honoraria from Bayer, Biogen, Biologix, Merck, Novartis, Roche, Sanofi; Research grants from Merck, Novartis; Advisory board fees from Bayer, Biogen,Merck, Novartis, Roche, Sanofi Joelle Massouh has received speakers’ honoraria, travel, grants and advisory board fees from AstraZeneca, Biogen, Biologix, Janssen, Merck, Novartis, Roche, and Sanofi. Ruquia Mir has received speaker's honoraria, advisory board fees and travel grants from Merck Sanofi Novartis Roche Suzan Noori has no disclosures. Bassem Yamout has received speaker's honoraria travel, grants and advisory board fees from Bayer, Biogen, Biologix, Genpharm, Merck, Novartis, Roche, Sanofi, Genzyme and research grants from Bayer, Biogen, Biologix, Merck, Novartis, Pfizer, (Copyright © 2024. Published by Elsevier B.V.)

Patients with multiple sclerosis (MS) should be vaccinated against COVID-19. All COVID-19 vaccines are effective and do not appear to carry any additional risk for patients with MS. Patients with MS should get a COVID-19 vaccine as soon as it becomes available. The risks of COVID-19 disease outweigh any potential risks from the vaccine. Even if vaccinated, patients with MS should continue to practice standard and recommended precautions against COVID-19, such as wearing a face mask, social distancing and washing hands. There is no evidence that patients with MS are at higher risk of complications from the mRNA, non-replicating viral vector, inactivated virus or protein COVID-19 vaccines, compared to the general population. COVID-19 Vaccines are safe to use in patients with MS treated with disease-modifying therapies (DMTs). The effectiveness of vaccination may be affected by few of the DMTs but yet some protection is still provided. For certain DMTs we may consider coordinating the timing of the vaccine with the timing of the DMT dose to increase vaccine efficacy., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: To describe the clinical and radiological characteristics of neuromyelitis optica spectrum disorders (NMOSD) patients from the Arabian Gulf relative to anti-aquaporin 4 antibody serostatus., Methods: Retrospective multicentre study of hospital records of patients diagnosed with NMOSD based on 2015 International Panel on NMOSD Diagnosis (IPND) consensus criteria., Results: One hundred forty four patients were evaluated, 64.3% were anti-AQP4 antibody positive. Mean age at onset and disease duration were 31±12 and 7 ± 6 years respectively. Patients were predominantly female (4.7:1). Overall; relapsing course (80%) was more common than monophasic (20%). Optic neuritis was the most frequent presentation (48.6%), regardless of serostatus. The proportion of patients (54.3%) with visual acuity of ≤ 0.1 was higher in the seropositive group (p = 0.018). Primary presenting symptoms of transverse myelitis (TM) were observed in 29% of patients, and were the most significant correlate of hospitalization (p<0.001). Relative to anti-APQ4 serostatus, there were no significant differences in terms of age of onset, course, relapse rates or efficacy outcomes except for oligoclonal bands (OCB), which were more often present in seronegative patients (40% vs.22.5%; p = 0.054). Irrespective of serostatus, several disease modifying therapies were instituted including steroids or immunosuppressives, mostly, rituximab and azathioprine in the cohort irrespective of serostatus. The use of rituximab resulted in reduction in disease activity., Conclusion: This is the first descriptive NMOSD cohort in the Arabian Gulf region. Seropositive patients were more prevalent with female predominance. Relapsing course was more common than monophasic. However, anti-AQP4 serostatus did not impact disease duration, relapse rate or therapeutic effectiveness. These findings offer new insights into natural history of NMOSD in patients of the Arabian Gulf and allow comparison with patient populations in different World regions., Competing Interests: Declaration of Competing Interest EN, AT, AK, MF, SN, MZ, SF, AA.A, JA, MJ. TA, AA, ME, RN, AG, IA, AM, NO, MQ, SA, KH has nothing to disclose E.Shosha has received honoraria for scientific lectures from Biologix, Merck, Hikma, travel payment from, Biologix, Sanofi, Merck, and Roche and served on the scientific advisory board for Biologix, Merck, and Sanofi. A. Al Asmi received honoraria for serving in scientific advisory board from Novartis, Merck, and Roche and travel payment from, Biologix, Bayer, Sanofi, Merck, Novartis, and Roche. J. Inshasi received honoraria for serving in scientific advisory board meetings from Biogen, Novartis, Merck, Sanofi and Roche Y. Al Malik received Compensation for advisory board participation and conference travel (Genzyme, Merck, and Roche). H. Alnajashi received honoraria as a speaker from Biogen, Novartis, and Roche. G. Altowaijri received honoraria for speaking for Novartis and advisory board for genzyme. F. Abdulla served in advisory board for Roche and Novartis Ibtisam A.Thubaiti worked on scientific advisory board for Merck-Serono and eceived speaker's honoraria from Novartis and Merck-Serono. R. Alroughani received honoraria as a speaker and for serving in scientific advisory board from Biogen, Bayer, Novartis, Merck, Sanofi and Roche., (Copyright © 2019 Elsevier B.V. All rights reserved.)