This virus has the distinct possibility of becoming a major disruption and a major danger to people with MS.
It is not too early to begin thinking about how you will personally deal with the situation should COVID-19 continue spreading. I am among the many who believe it will.
Here are some of my thoughts...
First, regarding treatment, it is important to understand the rate of serious infections with various MS DMT's. Based on a national study in Sweden between 2011 and the end of 2017 involving 6421 PwMS here are the results...
Glatiramer acetate (Copaxone) had a serious infection rate of 5.2 per 1000 patient years
Interferons... 8.9
Tysabri... 11.4
Gilyena... 14.3
Rituximab... 19.7
Ocrevus... 19.7 (predicted)
Ocrevus, not in the study, is virtually identical to rituximab, both kill CD20 B cells so the infection rate is fully expected to be virtually identical.
Please understand that the anti CD20 therapies are meds which kill infection fighting immune cells, rituximab and Ocrevus, take months and often years, to repopulate those cells. All other MS meds take considerably less time to repopulate those cells because they have not killed them.
For instance, Gilyena sequesters B cells in the lymph system and Tysabri prevents them from crossing the BBB and getting into the CNS, but neither kills the B cells. So, coming off those meds and the others for MS, quickly reconstitutes the immune system, if need be. Of course, slowing MS is why they are taken in the first so stopping is not a great option.
The point here is that information and knowledge are valuable to decision making. Personally, I cannot imagine a new patient going on Ocrevus with the possibility of COVID-19 becoming more prevalent. To me, it seems like needless risk when other meds are available with less rates of serious infection and which, if discontinued, do not require months or even years to reconstitute the immune system's infection fighting B cells.
My second thought is that I recall a Canadian national study which found 24% of PwMS died of pneumonia. COVID-19 is a respiratory virus, easily spread, not all who have it show symptoms, but it is dangerous to weakened immune systems.
I believe PwMS should begin thinking about how they might avoid exposure... social isolation, for example. I'm saying you should not isolate right now! I'm saying think about what you are going to do if the virus becomes widespread. Seriously.
Also, here is the Johns Hopkins site for tracking COVID-19 in each country...
https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6
It is not too early to begin thinking about how you will personally deal with the situation should COVID-19 continue spreading. I am among the many who believe it will.
Here are some of my thoughts...
First, regarding treatment, it is important to understand the rate of serious infections with various MS DMT's. Based on a national study in Sweden between 2011 and the end of 2017 involving 6421 PwMS here are the results...
Glatiramer acetate (Copaxone) had a serious infection rate of 5.2 per 1000 patient years
Interferons... 8.9
Tysabri... 11.4
Gilyena... 14.3
Rituximab... 19.7
Ocrevus... 19.7 (predicted)
Ocrevus, not in the study, is virtually identical to rituximab, both kill CD20 B cells so the infection rate is fully expected to be virtually identical.
Please understand that the anti CD20 therapies are meds which kill infection fighting immune cells, rituximab and Ocrevus, take months and often years, to repopulate those cells. All other MS meds take considerably less time to repopulate those cells because they have not killed them.
For instance, Gilyena sequesters B cells in the lymph system and Tysabri prevents them from crossing the BBB and getting into the CNS, but neither kills the B cells. So, coming off those meds and the others for MS, quickly reconstitutes the immune system, if need be. Of course, slowing MS is why they are taken in the first so stopping is not a great option.
The point here is that information and knowledge are valuable to decision making. Personally, I cannot imagine a new patient going on Ocrevus with the possibility of COVID-19 becoming more prevalent. To me, it seems like needless risk when other meds are available with less rates of serious infection and which, if discontinued, do not require months or even years to reconstitute the immune system's infection fighting B cells.
My second thought is that I recall a Canadian national study which found 24% of PwMS died of pneumonia. COVID-19 is a respiratory virus, easily spread, not all who have it show symptoms, but it is dangerous to weakened immune systems.
I believe PwMS should begin thinking about how they might avoid exposure... social isolation, for example. I'm saying you should not isolate right now! I'm saying think about what you are going to do if the virus becomes widespread. Seriously.
Also, here is the Johns Hopkins site for tracking COVID-19 in each country...
https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6
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