Medicus, Vol. 29 No. 2 COVID-19, 2020.
Review article
Treatment of Multiple Sclerosis During the COVID-19 Pandemic
Mario Habek
Abstract
Multiple disease-modifying therapies (DMTs) have been approved for the treatment of relapsing-remitting multiple sclerosis (RRMS). There are two approaches to treating MS. One approach is the continuous application of therapy (maintenance therapy), which can then be optimized depending on the course of the disease. Maintenance therapy includes interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab, S1P receptor modulators (fingolimod), and ocrelizumab. Another recent approach in the treatment of MS is immune reconstitution therapy. Immune reconstitution therapy includes alemtuzumab and cladribine. In general, with the exception of beta-interferon and glatiramer acetate, all other DMTs are associated with varying degrees of risk of infection. It is this increased risk of infection in MS with various DMTs that has become very relevant in the COVID-19 pandemic. It should be emphasized that we do not currently know whether people with MS are at increased risk of catching COVID-19 or developing severe COVID-19 disease. There is also no scientific evidence that the DMTs we use to treat MS affect the possibility of infection or the course of COVID-19 infection. Clearly, any decision to initiate DMTs during the COVID-19 pandemic must be made carefully and will depend on the state of the pandemic, not only in a specific country but also in a specific area where a person lives and receives therapy. In doing so, care should be taken to take a proactive approach to MS treatment and focus on the patient at all stages of the disease, in order to minimize its aftereffects and maximize the quality of life.
Keywords
multiple sclerosis; disease modifying therapy; infections; COVID-19
Hrčak ID:
244334
URI
Publication date:
30.9.2020.
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