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More considerations about COVID-19 and DMTs
Professor Gavin Giovannoni, at the BARTS-MS Centre in London, has written a very thoughtful post about COVID-19 and our MS disease-modifying treatments. Prof. G weighs, step by step, the risks and benefits of stopping or delaying an MS treatment due to this coronavirus and the COVID-19 illness it can cause.
It’s a long read, and somewhat complex, but it’s worth your while to read the whole post. For those who are in a rush, here’s a summary of Prof. G’s thoughts:
- The BARTS kidney transplant team isn’t making any specific changes to the levels of immunosuppression they are providing their transplant patients during the epidemic. It’s simply suggesting the usual protective measures of hand-washing, avoiding crowds, etc. Prof. G. writes “Their argument is that transplanted kidneys and other transplanted organs are too precious not to protect them with relevant immunosuppressive drugs. Why would we not have the same attitude about the brains and spinal cords of our patients with active multiple sclerosis?”
- It’s possible that that moderate immunosuppression may actually prevent severe complications associated with COVID-19 infection. The serious lung complications of COVID-19 seem similar to ARDS (acute respiratory distress syndrome). ARDS, in this case, may be caused by an over-exuberant immune response to the virus. In fact, the DMT Gilenya (fingolimod) is being tested as a treatment for COVID-19 associated ARDS.
- In Prof. G’s opinion, delaying treatment, de-escalating therapy by switching to immunomodulatory DMT, or interrupting dosing of DMTs to wait for a vaccine will delay the adequate treatment of MS. For some patients having their MS treated and controlled may be more important than the potential risk of being exposed to and acquiring a severe COVID-19 infection.
There’s much more in Prof. G’s post, and I strongly suggest that you click here and read the whole thing.
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1 Reply
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Have just been told by my MS Nurse at Charing Cross Hospital, London that letters are about to go out to suspend therapies because of the COVID-19 crisis.
I was talking to her about something else so did not have my journo hat on.
It sounded like a general suspension for the time being!
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