COVID-19 coronavirus and MS treatments
We know things are changing fast. This page sets out what we know about treatments right now. We’re keeping it under continual review as our knowledge of the virus improves over time. That means it's important you check this page regularly for updates. You can also sign up for our free COVID-19 and MS webinar on Wednesday 8 April.
Practical advice for people with MS
The latest UK government advice is for everyone to stay at home to reduce risk. That means only going out for food, health reasons or essential work. And keeping at least 2 metres away from other people when outside.
You might have had a letter, text or phone call from the government recommending you ‘shield’ (self-isolate at home for 12 weeks). This message has gone to a wide group of people, to make sure people at higher risk take action as quickly as possible.
You might have received this message even if you don’t meet the official criteria for “extremely vulnerable”. If you do get this message, you have a right to 12-week self-isolation. Find out what your local council can do to support you through the government website. You can also find more links to information and support at the bottom of this page.
If you're in the "extremely vulnerable" category because of your treatment with alemtuzumab (Lemtrada), cladribine (Mavenclad) or HSCT and live in England, you can self-register on the government website for extra help.
If you meet the criteria, or your MS team are concerned about your risk for other reasons (for example if you have other health conditions as well as MS), you’ll get a follow-up letter confirming you should be shielding for 12 weeks. It is very important you follow this advice.
- have significant difficulties with breathing or swallowing (for instance if you need artificial feeding)
- have taken alemtuzumab (Lemtrada) or cladribine (Mavenclad) within the last 12 weeks
- have had HSCT treatment in the last 12 months.
If you're self-isolating because of a recent course of alemtuzumab or cladribine, you generally will only need to self-isolate up to 12 weeks from the date of your course. So for example if you had an infusion of alemtuzumab 8 weeks ago, you should self-isolate for another 4 weeks.
If you are self-isolating because of HSCT, you should discuss the period of time with your transplant team as they may recommend longer.
If you think you or a loved one are in this highest risk category and have not received a letter or been contacted by your GP, get in touch with your GP or hospital doctor by phone or online.
Most other people with MS do not need to practice shielding. But there are other things that could put you at higher risk – some related to MS, some not.
This is a new virus, so it’s impossible to give a complete list of all the things that might increase risk. But here’s a general view from our medical advisors on the main risks you should think about when deciding how to protect yourself from the virus.
MS disease modifying therapies (DMTs) and coronavirus
DMTs affect your immune system, which can make your chances of infection, or complications from infection, higher. These risks are different for different DMTS, but generally they are moderate.
If you're taking a DMT and think you have coronavirus, you should be able to continue taking it if your symptoms are mild.
Here's what we know right now about specific DMTs.
Glatiramer acetate (Copaxone), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera), beta interferons, and natalizumab (Tysabri)
Glatiramer acetate (Copaxone), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera) and beta-interferons (various brand names) do not significantly increase your risk of infection as they don’t suppress your immune system.General advice for people on natalizumab (Tysabri) infusions is to still attend your appointments when you can, as there are risks to stopping these without careful planning. Speak to your MS team before making any changes. Some centres are moving MS-related infusions to more specific sites to minimise the risk of coming into contact with anyone with COVID-19 symptoms.
Fingolimod (Gilenya) may moderately increase your chances of viral infection, including COVID-19. However if you’re already taking fingolimod, stopping can lead to rebound MS disease activity. This could outweigh the risks of the virus.
If you’re thinking about beginning a course of fingolimod soon, you and your neurologist could consider an alternative DMT for now.
Alemtuzumab (Lemtrada) and cladribine (Mavenclad)
If you’re taking a course of alemtuzumab (Lemtrada), or cladribine (Mavenclad), you and your neurologist should consider delaying it. This is because these treatments can increase your risk of viral infections, especially in the few months following treatment.
The case for waiting could be particularly strong if you’re scheduled for a second or third course of treatment of one of these DMTs. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.
Before cancelling a course of treatment it’s important you first discuss it with your neurologist or MS team. It may be that once you understand the risks you want to continue, or there might be an alternative DMT you can take for the time being.
If you've taken alemtuzumab or cladribine within the last 12 weeks, you should also self-isolate until at least 12 weeks after the date of your course. So for example if you had an infusion of alemtuzumab 8 weeks ago, you should self-isolate for another 4 weeks.
Ocrelizumab (Ocrevus) is a highly effective treatment for MS but can also moderately increase your risk of viral infection. You and your neurologist may want to consider delaying this treatment as well.
The case for waiting could be particularly strong if you’ve already taken it and are scheduled for a follow-up infusion. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.
Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab
Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab (various brand names) are not available on the NHS, but some people get them by private prescription in the UK. These drugs could also affect your risk of getting COVID-19. If you’re taking any of them you should discuss your treatment with your neurologist or health professional.
Haematopoietic stem cell transplantation (HSCT)
HSCT is an intense chemotherapy treatment for MS. It aims to stop the damage MS causes by wiping out and then regrowing your immune system, using your stem cells. This treatment has a big effect on your immune system for a period of time. You and your neurologist and transplant team should consider delaying this treatment.
If you've had HSCT treatment in the last 12 months, speak to your transplant team about self-isolating. They may recommend you carry on for longer than 3 months post-treatment.
Steroids for MS relapses and coronavirus
Whether you should take steroids or not depends on your specific circumstances and how severe your relapse is. You should discuss it with your neurologist or MS team.
MS clinical trials and coronavirus
Advice about clinical trials will be different depending on what you’re testing. So you’re always best to speak directly to your trial team about it.
If you’re diagnosed with coronavirus COVID-19
If you think you have coronavirus and are taking a DMT, you should be able to continue taking it if your symptoms are mild.
If you're advised to go to your local hospital by any health professional, or go to hospital for any other reason, you should alert you MS team (even if you are not admitted). If you are taking a DMT they may want to discuss pausing or switching your treatment for the time being.
We updated this page on Friday 3 April 2020.
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We're constantly updating our information on coronavirus. So if you want to share it, please link to the page directly rather than quoting or summarising what we’ve said.
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