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. 2022 Jan;28(1):132-138.
doi: 10.1177/13524585211005339. Epub 2021 Mar 25.

Impact of COVID-19 on multiple sclerosis care and management: Results from the European Committee for Treatment and Research in Multiple Sclerosis survey

Emilio Portaccio  1 , Mattia Fonderico  2 , Bernhard Hemmer  3 , Tobias Derfuss  4 , Bruno Stankoff  5 , Krzysztof Selmaj  6 , Mar Tintorè  7 , Maria Pia Amato  8
Affiliations

Impact of COVID-19 on multiple sclerosis care and management: Results from the European Committee for Treatment and Research in Multiple Sclerosis survey

Emilio Portaccio et al. Mult Scler. 2022 Jan.

Abstract

Background: The spread of Coronavirus disease-19 (COVID-19) poses unique challenges in the management of people with multiple sclerosis (PwMS).

Objectives: To collect data about the impact of COVID-19 emergency on access to care for PwMS and on MS treatment practices.

Methods: Between March and July 2020, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) promoted an online survey covering patient access to care, management of relapses and visits, disease-modifying therapy (DMT) and experience with COVID-19.

Results: Three-hundred and sixty neurologists from 52 countries (68% from Europe) completed the survey. 98% reported COVID-19-related restrictions. Telemedicine was adopted to overcome the limited access to care and was newly activated (73%) or widely implemented (17%). 70% reported changes in DMT management. Interferons and glatiramer were considered safe. Dimethyl fumarate, teriflunomide and fingolimod were considered safe except for patients developing lymphopenia. No modifications were considered for natalizumab in 64%, cladribine in 24%, anti-CD20 in 22% and alemtuzumab in 17%; 18% (for alemtuzumab and cladribine) and 43% (for anti-CD20) considered postponing treatment.

Conclusion: The ECTRIMS survey highlighted the challenges in keeping standards of care in clinical practice. Telemedicine clearly needs to be implemented. Gathering data on DMT safety will remain crucial to inform treatment decisions.

Keywords: Coronavirus disease-19; Multiple sclerosis; access to care; disease-modifying treatment; telemedicine.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship and/or publication of this article: E.P. received compensation for travel grants, participation in advisory board and/or speaking activities from Biogen, Merck Serono, Sanofi, Teva and Novartis; serves on the editorial board of Frontiers in Neurology. M.F. has no conflicts of interest. B.H. has served on scientific advisory boards for Novartis; he has served as DMSC member for AllergyCare, Polpharma and TG therapeutics; he or his institution have received speaker honoraria from Desitin and his institution received research grants from Regeneron for MS research. He holds part of two patents: one for the detection of antibodies against KIR4.1 in a subpopulation of patients with MS and one for genetic determinants of neutralising antibodies to interferon. T.D. serves on scientific advisory boards for Novartis, Merck, Biogen, Genzyme, GeNeuro, Mitsubishi Pharma, Actelion, Roche, Alexion and Celgene; has received funding for travel and/or speaker honoraria from Biogen, Genzyme, Novartis, Merck and Roche, and received research support from Biogen, Novartis, Roche, the European Union, the Swiss National Science Foundation and the Swiss MS Society. B.S. reports grants and personal fees from Roche, Sanofi Genzyme and Merck Serono, and personal fees from Novartis, Biogen and Teva, outside the submitted work. K.S. received honoraria for speaking, consulting and serving for advisory boards for Merck, Novartis, Roche, Biogen, Celgene and TG therapeutics. M.T. has received compensation for consulting services and speaking honoraria from Almirall, Bayer Schering Pharma, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Sanofi-Aventis Viela-Bio and Teva Pharmaceuticals. She is co-editor of Multiple Sclerosis Journal – Experimental, Translational and Clinical. M.P.A. received compensation for consulting services and/or speaking activities from Bayer, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme and Teva Pharmaceutical Industries and received research support from Biogen Idec, Merck Serono, Roche, Pharmaceutical Industries and Fondazione Italiana Sclerosi Multipla. All conflicts are not relevant to the topic of the study.

Figures

Figure 1.
Figure 1.
Use of DMT in COVID-19 pandemic: (a) DMT use in treatment-naïve patients and (b) DMT switches in treated patients. DMT: disease-modifying treatment. Depleting agents includes ocrelizumab, rituximab, alemtuzumab, cladribine, mitoxantrone or cyclophosphamide.
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