Managing Disease-Modifying Therapies and Breakthrough Activity in Multiple Sclerosis Patients During the COVID-19...

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• The COVID-19 pandemic presents unique challenges for managing complex neurological disorders like multiple sclerosis (MS).
• Patients with MS have a higher risk of infections due to immune system impairment and treatments like disease-modifying therapies (DMTs).
• Current management strategies for MS during the pandemic lack consensus, particularly regarding the use of DMTs.

Purpose of the Study:

• To review the evidence for using DMTs in MS patients during the COVID-19 pandemic.
• To provide an algorithmic approach for managing MS patients, balancing DMT benefits against infection risks.
• To outline strategies for managing MS breakthrough activity during the pandemic.

Main Methods:

• Literature review analyzing evidence on DMT use in MS during the COVID-19 pandemic.
• Development of an algorithmic approach for clinical decision-making regarding DMT continuation or cessation.
• Guideline formulation for managing MS exacerbations and infections.

Main Results:

• DMTs modulate the immune response, increasing susceptibility to infections, a critical concern during the COVID-19 pandemic.
• An algorithmic approach helps optimize patient care by weighing the risks of infection against the potential for MS disease activation.
• Strategies are proposed to manage breakthrough MS activity while considering the pandemic context.

Conclusions:

• Careful consideration of DMTs is crucial for MS patients during the COVID-19 pandemic.
• An algorithmic approach can guide clinicians in managing MS treatment amidst infection risks.
• Proactive management of MS and infections is essential for patient well-being during global health crises.