MS News That Caught My Eye Last Week: COVID-19, Predicting Progression, Early Treatment, Estriol

Higher COVID-19 Risk Tied to 2 MS Therapies, Even With Vaccination

According to this study, people being treated with Ocrevus had 3.6 times the risk of a breakthrough COVID-19 infection compared with people being treated with most other disease-modifying therapies. For those treated with Gilenya, the risk was increased by 2.7 times. This Italian study reviewed people who received what was considered to be the full vaccination cycle in that country last year — either two or three mRNA vaccine doses or one vaccine dose and a certified COVID-19 infection.

Fully vaccinated multiple sclerosis (MS) patients who are treated with Ocrevus (ocrelizumab) or Gilenya (fingolimod) have a significantly higher risk of COVID-19 infection than those given other immunosuppressive therapies, according to a study in Italy.

Called breakthrough infections, these post-vaccination cases of SARS-CoV-2 — the virus that causes COVID-19 — also were more severe in Ocrevus-treated patients than in individuals with MS who received other disease-modifying therapies (DMTs).

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Levels of Certain Inflammatory Proteins May Predict Risk of Relapse

Which MS treatment to use and when to begin it are tough decisions for both the patient and the neurologist. The hope of these researchers is that being able to predict the risk of future relapses may help to direct more aggressive treatments to people at the highest risk.

Levels of certain inflammatory proteins in the cerebrospinal fluid, the liquid around the brain and spinal cord, may help to predict the risk of relapse activity for individuals with early multiple sclerosis (MS), a new study found.

High levels of three such proteins were predictive of a greater risk of a second relapse in people with early MS, according to researchers, who noted that the proteins “might be of value as prognostic biomarkers in early phases of multiple sclerosis.”

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Early RRMS Treatment Lessens Need for Disability Pension in Denmark

Some MS neurologists like to use the expression “brain is time.” The longer treatment is delayed, they believe, the greater the chance of brain atrophy and other central nervous damage. This study provides some evidence that early treatment allows people with MS to continue a productive work life longer than might otherwise be the case.

Delaying the start of disease-modifying therapies (DMTs) increases the risk of people with relapsing-remitting multiple sclerosis (RRMS) needing a disability pension to compensate for a permanent reduced capacity to work, according to a Danish study.

The study, “Time to first treatment and risk of disability pension in relapsing-remitting multiple sclerosis,” was published in the Journal of Neurology, Neurosurgery and Psychiatry.

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Estriol Plus Copaxone May Protect Against Nerve Damage in RRMS

Neurologists know that multiple sclerosis activity is frequently reduced during pregnancy. Estriol is an estrogen produced during pregnancy. So, would adding estriol to the Copaxone treatments of women with MS who aren’t pregnant have the same beneficial affect? This research reports it might.

Taking the pregnancy hormone estriol in combination with Copaxone (glatiramer acetate) significantly reduced the blood levels of neurofilament light chain (NfL) — a marker of nerve damage — in women with relapsing-remitting multiple sclerosis, clinical trial data show.

These lower NfL levels were significantly associated with a reduced brain lesion volume, a sign of MS-related tissue damage.

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