COVID stopped prescriptions

C

Williams T, Mishra R, Bharkhada B, Shields A, Dorsey R, Chataway J, Brownlee WJ. Impact of the COVID-19 pandemic on the prescription of disease-modifying therapy for multiple sclerosis in England: a nationwide study. J Neurol Neurosurg Psychiatry. 2022 Mar 10:jnnp-2021-328340. doi: 10.1136/jnnp-2021-328340.

The provision of multiple sclerosis (MS) services in England was profoundly impacted by the COVID-19 pandemic in 2020.

The Association of British Neurologists issued guidance in March 2020, advising that the risk from COVID-19 may potentially be increased with fingolimod, ocrelizumab, alemtuzumab and cladribine treatment in people with MS, due to the immunosuppressive mechanism of action of these drugs.

If the impacts of the COVID-19 pandemic were to reduce or delay the initiation of DMTs, particularly high-efficacy therapies, this may result in worse long-term outcomes for people with MS.

Here, we use national data on all DMTs prescribed in NHS England between January 2016 and December 2020 in order to assess whether the COVID-19 pandemic.

As a compulsory requirement of National Health Service (NHS) payment, all licenced DMTs prescribed for MS within NHS England must be registered on the Blueteq high-cost drug database.

They obtained fully anonymised data on the number of patients with MS initiated on each of the licenced DMT across all 77 MS centres. Between 2016 and 2019, the overall number of DMT initiations consistently increased (+29.5%). This was followed by a 13.3% reduction in the number of DMTs initiated in 2020 compared with 2019. The greatest absolute reductions in treatments initiated in 2020, compared with 2019, were seen with alemtuzumab (−75.0%), ocrelizumab (−13.5%)) and dimethyl fumurate (−13.5%). Natalizumab, the only high-efficacy monoclonal antibody treatment initially recommended as ‘safe’ during the COVID-19 pandemic, saw a 46.9% increase in the number of initiations in 2020 compared with 2019. Lower efficacy treatments, such as interferon-beta and glatiramer acetate, were relatively unaffected.

The Scottish Multiple Sclerosis Register has reported fewer new MS diagnoses in 2020 compared with previous years (16.7% reduction)), suggesting the impact on MS care extends beyond DMT initiation. Independent of the underlying cause, our findings of suboptimal DMT provision during 2020 indicate that the long-term impact of the COVID-19 pandemic may extend beyond the short-term disruptions in the care for people with MS.

So it was evident the the number of high efficacy treatments were reduced during the COVID-19 pandemic.

Disclaimer. These are the views of the author

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MouseDoctor

5 comments

  • Neurologists are a joke and the laughingstock of the rest of the medical world. Someone take these jokers’ licenses away so they stop harming patients by denying essential medicines.

    • I am not sure I agree withyour opinion here, they may be the eny off many if they have treatment opitions

  • Can’t be an “MS Warrior” when your dead. Just something to think about-

    This is a recent post from an Ocrevus Facebook site. Keep in mind the responses the women got were primarily of the “don’t worry, be happy” variety. The site is routinely policed by its founder for negative (in the founder’s opinion) feedback.

    “I’m on Ocrevus. Its worked so well for me. Problem is I believe it knocks your immune system down. I catch viruses like colds all the time. This time its COVID. I had the vaccine. Yet I got sick with COVID in August. Then again in January. This time, I’m still 46 days in hospitals now rehab. I’m serious thinking of stopping my MS treatment with Ocrevus. I can’t get sick again like this and live. I nearly didn’t survive. Has anyone else have trouble like this?”

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