Disease-Modifying Treatment (DMT) Guidelines for Coronavirus (COVID-19)

The Government of Canada and the U.S. Centers for Disease Control and Prevention (CDC) are following the outbreak of coronavirus (COVID-19), which causes a respiratory disease. This is a rapidly evolving situation and questions regarding the use of multiple sclerosis (MS) disease-modifying therapies (DMTs) during this outbreak are being raised.

The MS Society’s Medical Advisory Committee (Canada and U.S.) recommends the following:

1. People with MS should follow the Government of Canada and CDC guidelines and these additional recommendations for people at risk for serious illnesses from COVID-19.
2. People with MS should continue disease modifying therapies (DMTs) and discuss specific risks with their MS healthcare provider prior to stopping a DMT.
3. Before starting a cell depleting DMT* or a DMT that carries warnings of potentially severe increase in disability after stopping**, people with MS and their MS healthcare providers should consider specific risks (e.g. age, comorbid health conditions, location) and benefits.

These recommendations are the expert opinion of the Canadian and U.S. Medical Advisory Committees and are based on their clinical experience and assessment of the limited available data available regarding COVID-19 and MS DMTs. They have been endorsed by the Consortium of Multiple Sclerosis Centers (CMSC) and members of the MS Coalition***. We are continuing to monitor this quickly evolving situation and these recommendations may be modified as more data become available.

* Cell depleting therapies include: Lemtrada™ (alemtuzumab), Mavenclad™ (cladribine), Ocrevus™ (ocrelizumab) and Rituxan® (rituximab; used off-label in MS).

** DMTs with a warning of potentially severe increase in disability after stopping include: Gilenya™ (fingolimod) and Tysabri® (natalizumab).

*** Members of the MS Coalition include: Accelerated Cure Project for Multiple Sclerosis, Can Do MS, Consortium of Multiple Sclerosis Centers, International Organization of Multiple Sclerosis Nurses, MS Views and News, Multiple Sclerosis Association of America, Multiple Sclerosis Foundation, National Multiple Sclerosis Society and United Spinal Association