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Tuesday, March 17, 2020

Guidance for the use of disease modifying therapies during the COVID-19 pandemic

People with MS have asked for guidance on the use of Disease Modifying Therapies (DMTs) during the COVID-19 pandemic. There are numerous recommendations circulating that attempt to provide clarity and guidance, however, differences among the recommendations have created confusion. DMT decision making varies significantly from country to country, ranging from highly provider-directed to a collaborative decision-making model.
The MS Coalition has endorsed global advice from the MS International Federation on DMT use during the COVID-19 pandemic. Their recommendations provide detailed guidance for the initiation and continuation of DMTs
The MS Coalition has also endorsed recommendations from The National MS Society’s National Medical Advisory Committee, which believes DMT decisions should be individualized and made collaboratively between the person with MS and his/her healthcare provider.  These recommendations are:
  1. People with MS should follow CDC guidelines and these additional recommendations for people at higher risk for serious illnesses from COVID-19.
  2. People with MS should continue disease modifying therapies (DMTs) and discuss specific risks with their MS healthcare provider prior to stopping a DMT.
  3. Before starting a cell depleting DMT* or a DMT that carries warnings of potentially severe increase in disability after stopping**, people with MS and their MS healthcare providers should consider specific risks (e.g. age, comorbid health conditions, location) and benefits.
We are continuing to monitor this quickly evolving situation and these recommendations may be modified as data becomes available.
* Cell depleting therapies include: Lemtrada, Mavenclad, Ocrevus and Rituxan (used off-label in MS)
** DMTs with a warning of potentially severe increase in disability after stopping include: Gilenya and Tysabri

*** Members of the MS Coalition include: Accelerated Cure Project for Multiple Sclerosis, Can Do MS, Consortium of Multiple Sclerosis Centers, International Organization of Multiple Sclerosis Nurses, MS Views and News, Multiple Sclerosis Association of America, Multiple Sclerosis Foundation, National Multiple Sclerosis Society and United Spinal Association


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