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    • #19425
      John Connor
      Our [UK] MS Society medical advisors are closely following what’s happening with MS treatments and COVID-19 coronavirus. This page is based on their advice, advice from the NHS and guidelines from the Association of British Neurologists (ABN).

      We know things are changing fast. This page sets out what we know about treatments right now. We’re keeping it under continual review as our knowledge of the virus improves over time. That means it’s important you check this page regularly for updates.

      For information on social care, benefits, financial help and other support, see our coronavirus care and support page.

      Practical advice for people with MS

      The latest UK government advice is for everyone to practice social distancing to reduce risk. They’ve said people with chronic neurological conditions like MS should be particularly careful about following these steps:

      • Avoid contact with anyone who displays symptoms of coronavirus (COVID-19). Symptoms include high temperature and/or new and continuous cough
      • Try not to use public transport unless you really have to and, if you can, always avoid rush hour
      • Work from home where possible. Your employer should support you to do this. Read the government’s employer guidance for more information
      • Avoid large gatherings, and gatherings in smaller public spaces like pubs, cinemas, restaurants, theatres, bars, clubs
      • Avoid gatherings with friends and family.
      • Keep in touch using remote technology like phone, internet, and social media.
      • Use telephone or online services to contact your GP or other essential services

      Read more about social distancing and when to self-isolate

      MS disease modifying therapies (DMTs) and coronavirus

      If you think you have coronavirus, but don’t have a diagnosis, talk to your MS team about whether you should stop or change treatment.

      DMTs suppress your immune system, which can make your chances of catching an infection higher. But the risk is different for each one.

      Here’s what we know right now about specific DMTs.

      Glatiramer acetate (Copaxone), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera), beta interferons, and natalizumab (Tysabri)

      Glatiramer acetate (Copaxone), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera) and beta-interferons (various brand names) do not significantly increase your risk of infection as they don’t suppress your immune system.

      If you’re taking natalizumab (Tysabri) carry on as normal. We’ll be closely monitoring the situation and updating this page if anything changes.

      Fingolimod (Gilenya)

      Fingolimod (Gilenya) may slightly increase your chances of viral infection, including COVID-19. However if you’re already taking fingolimod, stopping can lead to rebound MS disease activity. This could outweigh the risks of the virus.

      If you’re thinking about beginning a course of fingolimod soon, you and your neurologist could consider an alternative DMT for now.

      Alemtuzumab (Lemtrada) and cladribine (Mavenclad)

      If you’re taking a course of alemtuzumab (Lemtrada), or cladribine (Mavenclad), you and your neurologist should consider delaying it. This is because these treatments can increase your risk of viral infections, especially in the few months following treatment.

      The case for waiting could be particularly strong if you’re scheduled for a second or third course of treatment of one of these DMTs. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.

      Before cancelling a course of treatment it’s important you first discuss it with your neurologist or MS team. It may be that once you understand the risks you want to continue, or there might be an alternative DMT you can take for the time being.

      Read about precautions you could take if you have recently had an infusion of alemtuzumab or cladribine on our coronavirus care and support page.

      Ocrelizumab (Ocrevus)

      Ocrelizumab (Ocrevus) is a highly effective treatment for MS but can also moderately increase your risk of viral infection. You and your neurologist may want to consider delaying this treatment as well.

      The case for waiting could be particularly strong if you’ve already taken it and are scheduled for a follow-up infusion. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.

      Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab

      Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab (various brand names) are not available on the NHS, but some people get them by private prescription in the UK. These drugs could also affect your risk of getting COVID-19. If you’re taking any of them you should discuss your treatment with your neurologist or health professional.

      Haematopoietic stem cell transplantation (HSCT)

      HSCT is an intense chemotherapy treatment for MS. It aims to stop the damage MS causes by wiping out and then regrowing your immune system, using your stem cells. This treatment greatly hampers your immune system for a period of time. You and your neurologist or healthcare professional should consider delaying this treatment.

      Read about precautions you could take if you have recently had HSCT on our coronavirus care and support page.

      Steroids for MS relapses and coronavirus

      Whether you should take steroids or not depends on your specific circumstances and how severe your relapse is. You should discuss it with your neurologist or MS team.

      MS clinical trials and coronavirus

      Advice about clinical trials will be different depending on what you’re testing. So you’re always best to speak directly to your trial team about it.

      If you’re diagnosed with coronavirus COVID-19

      If you think you have coronavirus, but don’t have a diagnosis, talk to your MS team about whether you should stop or change treatment.

      If a health professional confirms you have coronavirus COVID-19, they might advise you to stop taking your DMT.

      This means do not inject yourself or take your tablets. Contact your MS team as soon as you know and they will tell you when it’s safe to start taking them again.

      If you’re due to have an infusion this needs to be delayed.

      If you’re concerned please contact your neurologist or other health professional for more detailed advice.

      We updated this page on Monday 16 March 2020.

      Help prevent outdated information sharing

      We’re constantly updating our information on coronavirus. So if you want to share it, please link to the page directly rather than quoting or summarising what we’ve said.

      More information

      Go to our MS and coronavirus care and support page

      Go to the UK government coronavirus page

      Go to the NHS 111 coronavirus service

      Read the ABN coronavirus guidelines

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