CNS Demyelination and Autoimmune Neurology: Spencer Hutto, MD

“Everybody has these questions. How do patients with MS fare with COVID-19? How do we adjust their immunotherapies if they become infected? That's been a real challenge. Also, how do we balance their treatments while they're undergoing vaccinations? What are the best strategies for that? So, I think from just a clinical perspective, and from a research perspective, that's been a real challenge.”

Central nervous system (CNS) demyelination in patients treated with tumor necrosis factor alpha inhibitor (TNFαi) treatment can persist after discontinuation in prolonged follow-up, data from a recent study suggest. Spencer K. Hutto, MD, clinical fellow, Advanced General and Autoimmune Neurology, Massachusetts General Hospital, presented these findings virtually at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2021, February 25-27.

Hutto and colleagues found that TNFαi were discontinued at the onset of demyelinating events in 86% (n = 18) of patients, and 69% (n = 14) were treated acutely with steroids. Ultimately, 42% (n = 9) of patients used multiple sclerosis (MS) disease-modifying therapies (DMTs). Twelve patients (57%) had new disease activity over time, and clinical relapse was experienced by 48% (n = 10), with a median of 41 months to first relapse (range, 12-80). 

NeurologyLive reached out to Hutto to learn more about CNS demyelination and the work he and colleagues did. He discussed the overlap between autoimmune neurology and rheumatology, and also touched on questions concerning associations between MS and COVID-19.

For more coverage of ACTRIMS Forum 2021, click here.

REFERENCE

Hutto SK, Rice DR, Mateen FJ. Long-term outcomes of CNS demyelination associated with exposure to TNFa Inhibitors: A Retrospective cohort analysis. Presented at ACTRIMS Annual Forum; February 25-27, 2021. Abstract P165