COVID-19 and Multiple Sclerosis Disease Modifying Therapies v1.0
Research type
Research Study
Full title
Prevalence of coronavirus disease 2019 in people with multiple sclerosis taking disease modifying therapies in England
IRAS ID
289686
Contact name
Nikos Evangelou
Contact email
Sponsor organisation
Nottingham University Hospitals NHS Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research Summary
The coronavirus disease 2019 (COVID-19) pandemic has raised concerns for people on long-term treatments that affect the immune system. People with multiple sclerosis (pwMS) form a large group of patients who receive such treatments called disease modifying therapies (DMTs). Different types of DMTs are being used in the UK and each of them has a different effect on the immune system. The risk of COVID-19 associated with DMTs is currently unknown. Therefore, recommendations on the use of DMTs in pwMS and the measures they need to take during the pandemic are based on previous knowledge and experience about the risk of other infections among them. The risk of COVID-19 in pwMS on DMTs must be established before these recommendations are updated.
In this study, we intend to determine the prevalence and outcome of COVID-19 among pwMS who are taking DMTs and to understand whether individual DMTs pose different risks to pwMS based on their different mechanisms of action. We want to merge the data of pwMS currently on DMTs held by NHS England and NHS Improvement with data on those who have been tested for coronavirus held by Public Health England. Also, we will ask local NHS MS clinical teams to provide us with more information on pwMS on DMTs who have been tested for coronavirus.
We are particularly interested in whether patients have been given a clinical diagnosis of COVID-19, the severity of their disease, and the outcome in terms of recovery or death. The results will help us assess the risk of COVID-19 associated with individual DMTs. We are hoping to provide clear evidence for updating guidelines on DMT use and necessary precautions for pwMS during the COVID-19 pandemic.
Summary of Results
Multiple sclerosis (MS) is a disease of the brain and spinal cord. The immune system attacks the nervous system in MS and, therefore, many people with MS receive drugs that suppress or modify the function of the immune system with different mechanisms. There is a concern that the immune system might also fail to respond to COVID-19 vaccines as a result of using some of the stronger drugs that suppress the immune system. This study shows that people with MS taking ocrelizumab or fingolimod (both of which suppress the immune system- in particular the cells that are responsible for responding to vaccines) are at increased risk of contracting COVID-19 compared to other MS drugs. Also, these patients may have more severe disease if they get COVID-19, but the risk is small. These findings are in line with other studies on a smaller number of patients. All results can also be found in our publications and presentations (the links have been provided above).
REC name
London - Westminster Research Ethics Committee
REC reference
20/PR/0865
Date of REC Opinion
22 Jan 2021
REC opinion
Favourable Opinion