Article provided by: Cherie C. Binns RN BS MSCN
Treating MS During COVID-19
Written by Judy George, Senior Staff Writer, MedPage Today
March 30, 2020
Treating MS During COVID-19
Written by Judy George, Senior Staff Writer, MedPage Today
March 30, 2020
Click HERE to Register for the MS Beacon Newsletter
Most people with multiple sclerosis (MS) should continue their disease-modifying treatment (DMT) during the COVID-19 outbreak and should discuss specific risks with their physician before stopping, according to the National MS Society’s Disease Modifying Treatment Guidelines for COVID-19.
Newly diagnosed MS patients should start treatment, but “many factors need to be considered when starting any DMT, including the possible increased risk of COVID-19 infection,” said Kathleen Costello, MS, CRNP, MSCN, the MS Society’s vice president of healthcare access. “Cell-depleting DMTs may increase the risk of infection, including COVID-19, and this potential risk must be weighed against other factors when starting a DMT.”
The guidelines are the recommendations of the MS Society’s National Medical Advisory Committee, a group of experts who advise the organization’s leadership about medical issues in MS.
“There are no data currently available on the risk of COVID-19 infection in people with MS who are on DMTs,” Costello told MedPage Today. To develop guidance during the COVID-19 pandemic, “the committee reviewed the data known about DMTs and the risk for infection associated with each and COVID-19 DMT guidance from Italy and the U.K.,” she said.
“The committee also recommended that people use the global advice provided from the Multiple Sclerosis International Federation, keeping in mind that each decision is highly individualized and the risks and benefits of starting any of the DMTs needs a thorough discussion,” Costello added.
The guidelines described three groups of treatments:
- Immunomodulators that generally do not suppress the immune system or place patients at greater risk of infection, such as glatiramer acetate (Copaxone, Glatopa), interferons (Betaseron, Rebif, Avonex, Extavia, Plegridy), and natalizumab (Tysabri)
- Immunomodulators that restrict the ability of the immune system to respond to infection, including dimethyl fumarate (Tecfidera), diroximel fumarate (Vumerity), fingolimod (Gilenya), siponimod (Mayzent), and teriflunomide (Aubagio)
- Immunosuppressants that deplete lymphocytes, such as alemtuzumab (Lemtrada), cladribine (Mavenclad), mitoxantrone (Novantrone), ocrelizumab (Ocrevus), and rituximab (Rituxan)
Before starting a cell-depleting DMT — or a DMT with warnings about a potential severe increase in disability after stopping, like fingolimod or natalizumab — clinicians should consider a patient’s specific risks, including age and comorbid health conditions, versus the drug’s benefits, the guidance committee cautioned.
As information about COVID-19 in MS emerges, the guidelines will be updated, Costello said. Of note, the Consortium of MS Centers and the other members of the MS Coalition have endorsed the National MS Society guidance, she added.
“We just don’t have answers to guide people with MS,” observed Robert Fox, MD, of the Cleveland Clinic in Ohio, who was not part of the MS Society guidelines committee.
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
This article is posted and shared by: #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Visit our MS Learning Channel on YouTube: http://www.youtube.com/msviewsandnews