Fast and safe: Optimising multiple sclerosis infusions during COVID-19 pandemic

Abstract

Background: The COVID-19 pandemic challenges multiple sclerosis services to be innovative in delivering infusible therapies. To reduce time in clinical settings, and potential staff or space losses, we implemented rapid infusion protocols for selected patients. Objective: To analyse the rate of infusion related reactions and patient experience of rapid infusions of natalizumab and ocrelizumab. To document time reduction patients spent in clinical settings during the COVID-19 pandemic. Methods: Patients with prior exposure to at least three natalizumab or two 300mg ocrelizumab infusions were approved for rapid protocols. A retrospective audit and survey were completed. Results: We analysed 269 rapid natalizumab infusions and 100 rapid ocrelizumab infusions. Infusion related reactions during the natalizumab or ocrelizumab infusions occurred in two patients (1.52%) and eight patients (8%), respectively. All infusion related reactions were mild to moderate and did not require infusion discontinuation. No infusion reactions occurred during the post-infusion observation. Patient experience was positive. Conclusion: Frequency or severity of infusion related reactions in rapid infusions were no different compared to published data. In the setting of COVID-19, pandemic rapid infusion protocols could potentially save hospital resources and limit patient exposure to a high-risk clinical setting while still maintaining ongoing treatment of multiple sclerosis.

A National Representative, Cross-Sectional Study by the Hellenic Academy of NeuroImmunology (HEL.A.NI.) on COVID-19 and Multiple Sclerosis: Overall Impact and Willingness Toward Vaccination

“…Several scientific organizations are recommending alterations in the management of multiple sclerosis (MS) ( 3 – 5 ). These changes aim to minimize the direct interaction of patients with the health system, thus reducing the risk of exposure and infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ( 6 , 7 ). Effective ways of interacting (e.g., platforms and other telemedicine technologies) for PwMS and their caregivers with MS centers and the related facilities of public health are currently being investigated to allow for medical consultation services and disease management in the absence of physical presence ( 8 – 10 ).…”

Personalizing ocrelizumab treatment in Multiple Sclerosis: What can we learn from Sars-Cov2 pandemic?

“…In this scenario, in addition to rapid infusion protocols implementation [ 10 ], our MS centre adopted a personalized infusion schedule based on MS severity and the risk of developing severe COVID-19 related complications. In particular, we decided to delay ocrelizumab treatment in 56 of the 83 RRMS patients whose infusion was scheduled between March and December 2020.…”

Ocrelizumab: A Review in Multiple Sclerosis

“…3). Shorter infusion times have the potential to reduce resource utilization and may be preferred by patients [51].…”