JNNP: Impact of the COVID-19 pandemic on treatment options for multiple sclerosis in the UK

Concerns have been raised about the safety of immunosuppressive disease-modifying therapies (DMTs) in the UK, where multiple sclerosis (MS) treatment has been impacted by COVID-19, reducing access to diagnosis and infusion therapy in hospital facilities
.

The British Association of Neurologists published COVID-19 guidelines in March 2020 on the risks of fenolimod, oclimumab, alemtuzumab and cladribine in patients with MS due to the immunosuppressive mechanism of these drugs may increase

All DMT prescribed in NHS England between January 2016 and December 2020 using national data to assess whether the COVID-19 pandemic was associated with a change in DMT treatment in MS in 2020

As a mandatory requirement of the National Health Service (NHS), all licensed DMTs prescribed by the UK National Health Service (NHS) for MS must be registered in the Blueteq High Cost Medicines database
.

These data included all 77 patient MS centres in England

The total number of DMT treatments continued to increase between 2016 and 2019, from 7241 in 2016 to 9377 in 2019 (+29.

5%)

Natalizumab, the only high-potency monoclonal antibody therapy recommended as "safe" during COVID-19, saw a 46.

A longitudinal national survey of all mandated DMTs in the UK MS population between 2016 and 2020 found that the onset of the COVID-19 epidemic in 2020 coincided with changes in national prescribing patterns
.

Recently, the trend of increasing the number of DMT treatments has reversed, with the largest decrease in the number of highly potent monoclonal antibody therapies

Pre-COVID-19 use of alemtuzumab was increased by OCRILUMUAB prescribing, resulting in a 46.

The 46.
9% increase in 2020 was not enough to counter the declines in alemtuzumab and oclimumab
.
Despite initial concerns about immunosuppressive DMTs during the COVID-19 pandemic, registry studies have not identified an increased risk of severe COVID-19 for most available MS treatments
.
The 46.
9% increase in 2020 was not enough to counter the declines in alemtuzumab and oclimumab
.
Despite initial concerns about immunosuppressive DMTs during the COVID-19 pandemic, registry studies have not identified an increased risk of severe COVID-19 for most available MS treatments
.
WilliamsT ,MishraR ,Bharkhada  B Williams  T Williams Mishra  R Mishra Bharkhada  B Bharkhada , et al Impact of the COVID-19 pandemic on the prescription of disease-modifying therapy for multiple sclerosis in England: a nationwide study Journal of Neurology, Neurosurgery & Psychiatry  Published Online First: 10 March 2022.
  Published Online First: doi:  10.
1136/jnnp-2021-328340 doi:leave a message here