b'Medicine & Researchin the CNS. Weve gone from no FDA-approvedDr. ThrowerThe COVID-19 pandemic has therapies in 1992 to more than 20 approvedpresented some unique challenges to the MS options currently. Part of that evolution hascommunity. Disease-modifying therapies are been the development of more efficaciousevolving towards more effective options. With therapies and the use of those therapies earlierthat evolution comes the risk of compromising during MS. HSCT could represent one of thethe human immune system and increasing mosteffectiveimmunetherapiespossible.the risk of infections. B-cell therapiesOcrevus, HSCT essentially erases the existing immuneRituxan, Kesimpta and Truximatarget the system with chemotherapeutic agents andCD-20 receptor on B cells as their mechanism then resets it by using bone marrow-derivedof action. This class of medications can be stem cells from the patient. As with many morehighly effective in managing relapsing forms efficacious therapies, there is the potential forof MS. Ocrevus is our only FDA-approved more risk. This study conrms what othersoption for PPMS. These medications can be have shown. HSCT appears to work best inassociated with a higher risk for infections, RRMS as opposed to progressive forms ofincluding upper respiratory infections. This MS. It is quite effective at preventing relapsesstudy shows that B-cell therapies were linked and slowing disability. As we learn more andto a higher risk of more severe COVID-19 improve safety, perhaps one day HSCT willinfections. Antibody production can be reduced be a mainstream option in our MS therapyas well with anti-CD20 therapies and this can toolbox.lead to decreased effectiveness of vaccinations, including the COVID-19 vaccines.Study links B-cell therapies,B-cell therapies remain a very effective COVID-19 infection severitytool in managing MS. The majority of patients Data from 12 sources in 28 countries wereon these treatments have had no issues with aggregated by researchers and reviewed basedinfections of any kind. Any time we modulate on demographics, type of MS, and DMTs forthe immune system with a medication, we COVID-19 severity outcomes, hospitalization,must consider the risks and benets and do ICU admission, requiring articial ventilation,appropriate safety monitoring. This new data and death. Suspected and conrmed cases ofdoes not mean that people with MS need to COVID-19 were included resulting in 2,340stop these medications. If you are on a B-cell patients to compare. Older age, progressivetherapy, speak with your MS healthcare team MS-phenotype, and higher disability linkedabout risks and benets, dosing, and the timing to worse COVID-19 outcomes. There wereof vaccinations. consistent associations of rituximab withTysabri dosing once every six weeks increased risk of hospitalization, ICU admission,as effective as once every four and requiring artificial ventilation; and ocrelizumabwithhospitalizationandICUTysabri Observational Program data was admission. This study was published inused to identify 219 pairs of patients with Neurology.relapsing-remitting MS. Each pair consisted msfocusmagazine.org 54'