Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA.
Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA.
Ann Clin Transl Neurol. 2021 Apr;8(4):938-943. doi: 10.1002/acn3.51342. Epub 2021 Mar 30.
We conducted a retrospective cohort study in Kaiser Permanente Southern California from 1 January 2020 to 30 September 2020. We found that rituximab-treated persons with multiple sclerosis (pwMS, n = 1895) were more likely be hospitalized (n = 8, 33.3%), but not die (n = 0) from COVID-19, compared to the 4.81 million non-MS population (5.8% and 1.4%, respectively). Time in months (adjusted OR = 0.32, 95% CI = 0.15-0.69, p = 0.0033) and receiving 1000 mg compared to lower doses at last infusion (adjusted OR = 6.28, 95% CI = 1.38-28.5, p = 0.0173) were independent predictors of COVID-19 severity. Rituximab-treated pwMS should be counseled to take extra precautions in the 5 months following each infusion. Using extended dosing intervals and lower doses could be considered.
我们在 Kaiser Permanente Southern California 进行了一项回顾性队列研究，时间为 2020 年 1 月 1 日至 2020 年 9 月 30 日。我们发现，与 481 万非多发性硬化症人群（分别为 5.8%和 1.4%）相比，接受利妥昔单抗治疗的多发性硬化症患者（pwMS，n=1895）更有可能因 COVID-19 住院（n=8，33.3%），但不会死亡（n=0）。随访期间每增加一个月（调整后的比值比[OR] = 0.32，95%置信区间[CI] = 0.15-0.69，p=0.0033）以及最后一次输注时接受 1000mg 剂量而非较低剂量（调整后的 OR = 6.28，95% CI = 1.38-28.5，p=0.0173）与 COVID-19 严重程度独立相关。应建议接受利妥昔单抗治疗的 pwMS 在每次输注后的 5 个月内采取额外的预防措施。可以考虑延长给药间隔和降低剂量。
