A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic

Anoushka P Lal; Yi Chao Foong; Paul G Sanfilippo; Tim Spelman; Louise Rath; David Levitz; Marzena Fabis-Pedrini; Matteo Foschi; Mario Habek; Tomas Kalincik; Izanne Roos; Jeannette Lechner-Scott; Nevin John; Aysun Soysal; Emanuele D'Amico; Riadh Gouider; Saloua Mrabet; Katrin Gross-Paju; Simón Cárdenas-Robledo; Abdorreza Naser Moghadasi; Maria Jose Sa; Orla Gray; Jiwon Oh; Stephen Reddel; Sudarshini Ramanathan; Talal Al-Harbi; Ayse Altintas; Todd A Hardy; Serkan Ozakbas; Raed Alroughani; Allan G Kermode; Andrea Surcinelli; Guy Laureys; Sara Eichau; Alexandre Prat; Marc Girard; Pierre Duquette; Suzanne Hodgkinson; Cristina Ramo-Tello; Davide Maimone; Pamela McCombe; Daniele Spitaleri; Jose Luis Sanchez-Menoyo; Mehmet Fatih Yetkin; Seyed Mohammad Baghbanian; Rana Karabudak; Abdullah Al-Asmi; Gregor Brecl Jakob; Samia J Khoury; Masoud Etemadifar; Vincent van Pesch; Katherine Buzzard; Bruce Taylor; Helmut Butzkueven; Anneke Van der Walt

doi:10.1007/s00415-024-12518-7

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A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic

Journal article

Open access

Peer reviewed

A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic

Anoushka P Lal, Yi Chao Foong, Paul G Sanfilippo, Tim Spelman, Louise Rath, David Levitz, Marzena Fabis-Pedrini, Matteo Foschi, Mario Habek, Tomas Kalincik, …

Journal of neurology, Vol.271, pp.5813-5824

2024

DOI: https://doi.org/10.1007/s00415-024-12518-7

PMID: 38935148

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Abstract

Background The COVID-19 pandemic raised concern amongst clinicians that disease-modifying therapies (DMT), particularly anti-CD20 monoclonal antibodies (mAb) and fingolimod, could worsen COVID-19 in people with multiple sclerosis (pwMS). This study aimed to examine DMT prescribing trends pre- and post-pandemic onset. Methods A multi-centre longitudinal study with 8,771 participants from MSBase was conducted. Two time periods were defined: pre-pandemic (March 11 2018–March 10 2020) and post-pandemic onset (March 11 2020–11 March 2022). The association between time and prescribing trends was analysed using multivariable mixed-effects logistic regression. DMT initiation refers to first initiation of any DMT, whilst DMT switches indicate changing regimen within 6 months of last use. Results Post-pandemic onset, there was a significant increase in DMT initiation/switching to natalizumab and cladribine [(Natalizumab-initiation: OR 1.72, 95% CI 1.39–2.13; switching: OR 1.66, 95% CI 1.40–1.98), (Cladribine-initiation: OR 1.43, 95% CI 1.09–1.87; switching: OR 1.67, 95% CI 1.41–1.98)]. Anti-CD20mAb initiation/switching decreased in the year of the pandemic, but recovered in the second year, such that overall odds increased slightly post-pandemic (initiation: OR 1.26, 95% CI 1.06–1.49; Switching: OR 1.15, 95% CI 1.02–1.29. Initiation/switching of fingolimod, interferon-beta, and alemtuzumab significantly decreased [(Fingolimod-initiation: OR 0.55, 95% CI 0.41–0.73; switching: OR 0.49, 95% CI 0.41–0.58), (Interferon-gamma-initiation: OR 0.48, 95% CI 0.41–0.57; switching: OR 0.78, 95% CI 0.62–0.99), (Alemtuzumab-initiation: OR 0.27, 95% CI 0.15–0.48; switching: OR 0.27, 95% CI 0.17–0.44)]. Conclusions Post-pandemic onset, clinicians preferentially prescribed natalizumab and cladribine over anti-CD20 mAbs and fingolimod, likely to preserve efficacy but reduce perceived immunosuppressive risks. This could have implications for disease progression in pwMS. Our findings highlight the significance of equitable DMT access globally, and the importance of evidence-based decision-making in global health challenges.

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Title: A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic
Authors/Creators: Anoushka P Lal
Yi Chao Foong
Paul G Sanfilippo
Tim Spelman
Louise Rath
David Levitz
Marzena Fabis-Pedrini
Matteo Foschi
Mario Habek
Tomas Kalincik
Izanne Roos
Jeannette Lechner-Scott
Nevin John
Aysun Soysal
Emanuele D'Amico
Riadh Gouider
Saloua Mrabet
Katrin Gross-Paju
Simón Cárdenas-Robledo
Abdorreza Naser Moghadasi - The Alfred Hospital
Maria Jose Sa
Orla Gray - Alfred Hospital
Jiwon Oh
Stephen Reddel
Sudarshini Ramanathan
Talal Al-Harbi
Ayse Altintas
Todd A Hardy
Serkan Ozakbas
Raed Alroughani - Alfred Hospital
Allan G Kermode
Andrea Surcinelli - The Alfred Hospital
Guy Laureys
Sara Eichau
Alexandre Prat
Marc Girard
Pierre Duquette
Suzanne Hodgkinson
Cristina Ramo-Tello
Davide Maimone
Pamela McCombe
Daniele Spitaleri
Jose Luis Sanchez-Menoyo
Mehmet Fatih Yetkin
Seyed Mohammad Baghbanian
Rana Karabudak
Abdullah Al-Asmi
Gregor Brecl Jakob
Samia J Khoury
Masoud Etemadifar
Vincent van Pesch
Katherine Buzzard
Bruce Taylor
Helmut Butzkueven
Anneke Van der Walt - Alfred Hospital
Publication Details: Journal of neurology, Vol.271, pp.5813-5824
Publisher: Springer Nature
Identifiers: 991005682230707891
Murdoch Affiliation: Institute for Immunology and Infectious Diseases
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.203 Neuromuscular Disorders; 1.203.147 Multiple Sclerosis
Web Of Science research areas: Clinical Neurology
ESI research areas: Neuroscience & Behavior