No worries: MS patients have few concerns about COVID-19 and DMTs

Multiple sclerosis

By Michael Woodhead

20 Oct 2020

Australian patients with MS have little or no anxiety about treatment-related risks of COVID-19 and most are willing to continue their disease modifying therapy (DMT), a survey has found.

While there have been some potential concerns raised about the use of immunomodulatory therapies and the risk of contracting COVID-19 and its outcomes, these are not causing undue anxiety among patients, according to a study of patients being treated at the Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital.

Responses from 100 patients taking natalizumab, showed most had either no concern (50%) or were only mildly concerned (37%)  regarding their treatment in relation to COVID-19. Of the remainder, 8% said they were moderately concerned and 4% were highly concerned.

Similar responses were seen with patients treated with B-cell depleting therapies such as ocrelizumab, with 38% saying they were not all concerned and 46% reporting only mild concern about COVID-19 and their therapy. A slightly high proportion 16% reported moderate concern.

The main concerns raised by patients were not having access to their DMT due to COVID-19 or sustaining a relapse either because of missed treatment or contracting COVID-19.

Concerns about relapse were more common than those related to increased risk of contracting COVID-19 or poorer outcomes if they contracted the virus.

Patients receiving ocrelizumab (63%) expressed a slightly higher level of concern over their risk of contracting COVID-19 compared to those receiving natalizumab (54%), though responses were otherwise fairly similar.

Few patients reported concern over life-style factors (with examples given including an inability to leave the house, not being able to find employment).

More than half of patients (57%) said they were following government advice in relation to social distancing with greater stringency than recommended. However few (12%) wore masks or gloves in public. Similarly, only a small number (4%) said they were changing their therapy, while 12% said they had reduced medical appointments to avoid exposure to COVID-19.

The most common source of guidance for MS patients was government-based resources (61%), followed by consultation with their neurologist (35%) and with their GP (26%).

The study investigators cautioned that their findings were from just one centre in Victoria, which was more affected by COVID-19 and lockdowns than other states.

Nevertheless, they said it showed that while patients were aware of the theoretical risks with their DMT in relation to COVID-19, most remained open to continuing their therapy without significant apprehension.

“As reported outcomes become increasingly available as the pandemic evolves, clinicians may better be able to address patient concerns regarding their DMT safety in relation to COVID-19, drawing on real-world data, and where appropriate, counsel patients to continue their DMT’s, where the benefit of continuing is thought to outweigh the risks pertaining to COVID-19,” they concluded.

The survey findings are published in Multiple Sclerosis and Related Disorders journal.

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