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COVID-19 coronavirus and MS treatments

Our MS Society medical advisors are closely following what’s happening with MS treatments and COVID-19 coronavirus. This page is based on their advice, advice from the NHS and guidelines from the Association of British Neurologists.

We updated this page on Friday 6 November. It’s based on guidelines from the Association of British Neurologists (ABN). Follow links for updates to:

We know things are changing fast. This page sets out what we know about treatments right now. We’re keeping it under continual review as our knowledge of the virus improves over time. That means it's important you check this page regularly for updates

Find out about risk, getting shopping, shielding, benefits and financial and caring support

MS disease modifying therapies (DMTs) and coronavirus

DMTs affect your immune system, which can make your chances of infection, or complications from infection, higher. These risks are different for different DMTS, but generally they are moderate.

If you're taking a DMT and think you have coronavirus, you should be able to continue taking it if your symptoms are mild.

Read the full Association of British Neurologists (ABN) guidelines on MS disease modifying therapies and COVID-19 

DMT monitoring

In some cases, you may get less frequent blood tests to monitor your DMT. Centres will try to avoid any delays to blood tests.

The ABN guidance includes changes they judge are safe if your centre can't provide the usual number of tests because of their coronavirus response. We’ve added this ‘recommended monitoring’ below, to the information on each DMT available on the NHS.

DMT delivery

If you have homecare services for delivery of your DMT, generally these should carry on without a problem. If they are delayed or you have any difficulties contact your MS team immediately.

Read what to do if you think you have coronavirus COVID-19

Local risk of COVID-19 and DMTs

The chances of getting COVID vary across the UK. Your MS team will be able to to find out the level of risk in your area and how that might affect DMT treatment. This level of risk might not always match the levels of government restrictions where you are. 

In general, before cancelling a course of treatment it’s important you first discuss it with your neurologist or MS team. It may be that once you understand the risks you want to continue, or there might be an alternative DMT you can take for the time being.

Here's what we know right now about specific DMTs.

Glatiramer acetate (Copaxone and Brabio), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera), beta interferons, and natalizumab (Tysabri)

Glatiramer acetate (Copaxone and Brabio), teriflunomide (Aubagio), dimethyl fumarate (Tecfidera) and beta-interferons (various brand names) do not significantly increase your risk of infection as they don’t suppress your immune system. You can take them even if there’s a high local risk of coronavirus infection.

General advice for people on natalizumab (Tysabri) infusions is to still attend your appointments when you can. As with all DMTs you should speak to your MS team if you are worried about being able to continue treatment. Your team might suggest extending the time between infusions to reduce the risks from travelling to the clinic.

The local effects of COVID-19 might change how often you have blood tests. This is the ABN’s recommended monitoring until testing can get back to normal:

  • glatiramer acetate (Copaxone and Brabio), none required
  • teriflunomide (Aubagio), every month for the first 6 months, then every 4 months if stable
  • dimethyl fumarate (Tecfidera), every 6 months if stable and your lymphocyte count is above 0.5
  • beta interferons, 3 months after starting then none required
  • natalizumab (Tysabri), every 6 months testing for JC virus (the virus that can cause PML)

Fingolimod (Gilenya)

Fingolimod (Gilenya) may moderately increase your chances of viral infection, including COVID-19. However if you’re already taking fingolimod, stopping can lead to rebound MS disease activity. This could outweigh the risks of the virus. So whatever your local risk, you and your MS team might decide it’s ok to use. If the risk is high in your area, your team are likely to be more cautious, but this wouldn’t rule it out completely.

The local effects of COVID-19 might change how often you have blood tests. This is the ABN’s recommended monitoring until testing can get back to normal

  • every 6 months in first year, then every 12 months if stable

Alemtuzumab (Lemtrada)

The ABN note that there is very little evidence to assess the risk of alemtuzumab (Lemtrada) and severe COVID-19. 

If the local risk of infection is high you and your neurologist should consider delaying it. The case for waiting could be particularly strong if you’re scheduled for a second or third course of treatment. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.

If you take a course of alemtuzumab you should self-isolate at home for 4 weeks.

Read what to do if you've recently had an infusion of alemtuzumab

The local effects of COVID-19 might change how often you have blood tests. This is the ABN’s recommended monitoring until testing can get back to normal:

  • every 3 months

Cladribine (Mavenclad)

The ABN say that cladribine (Mavenclad) can be used “cautiously” as there is limited evidence about risk of severe COVID-19, so this will need to be balanced carefully against the potential benefits. You should closely follow social distancing and hygiene measures which help prevent infection.

If you’re scheduled for a second course of treatment, a delay of a few months is unlikely to affect the clinical progression of your MS.

The ABN do not recommend a period of self-isolation after a course of cladribine, because there is no defined point at which risks decrease. However you should continue to be very careful and closely follow social distancing and hygiene measures.

Read what to do if you've recently had a course of cladribine

Recommended monitoring until the risk of coronavirus is clearer or has passed:

  • 2 months after starting. If this shows you’re stable and have a lymphocyte count above 0.5, a test scheduled for 6 months after starting can be delayed. 

Ocrelizumab (Ocrevus)

Ocrelizumab (Ocrevus) is a highly effective treatment for MS but can also moderately increase your risk of viral infection.

For relapsing MS, the ABN say ocrelizumab can be used “cautiously” as the benefits of the drug will need to be balanced carefully against possible increased risks - as there is some evidence that people treated with ocrelizumab are more likely to be hospitalised with COVID-19 and to need intensive care.

If you’ve already taken it and are scheduled for a follow-up infusion your neurologist may recommend you delay this if there is very high local risk of infection. A delay of a few months is relatively unlikely to affect the clinical progression of your MS.

For primary progressive MS, the ABN do not rule out ocrelizumab but say that its benefits may be outweighed by the risks. This is because there are often higher risks from COVID-19 for people with primary progressive MS, like more advanced disability or other health conditions as well as MS.

The local effects of COVID-19 might change how often you have blood tests. This is the ABN’s recommended monitoring until testing can get back to normal:

  • none required

Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab

Siponimod (Mayzent), ofatumumab (Arzerra) and rituximab (various brand names) are not available on the NHS, but some people get them by private prescription in the UK. These drugs could also affect your risk of getting COVID-19. If you’re taking any of them you should discuss your treatment with your neurologist or health professional.

Haematopoietic stem cell transplantation (HSCT)

HSCT is an intense chemotherapy treatment for MS. It aims to stop the damage MS causes by wiping out and then regrowing your immune system, using your stem cells. This treatment has a big effect on your immune system for a period of time. Your neurologist and transplant team would only provide this treatment in exceptional cases.

If you've had HSCT treatment in the last 12 months, speak to your transplant team about self-isolating. 

Read what to do if you've recently had HSCT

Steroids for MS relapses and coronavirus

Whether you should take steroids or not depends on your specific circumstances and how severe your relapse is. You should discuss it with your neurologist or MS team.

You should self-isolate for two weeks after taking the kind of high-dose steroids that might be used to treat an MS relapse (for example methylprednisolone). This is because there is evidence that these temporarily increase the risk of severe Covid-19.

MS clinical trials and coronavirus

Advice about clinical trials will be different depending on what you’re testing. So you’re always best to speak directly to your trial team about it.

If you’re diagnosed with coronavirus COVID-19

If you think you have coronavirus and your symptoms are mild, you usually won’t need to stop taking your DMT if you use: 

  • interferon beta 
  • Glatiramer acetate (Copaxone)
  • Teriflunomide (Aubagio)
  • dimethyl fumarate (Tecfedira)
  • or fingolimod (Gilenya)

Treatments with infusions and with cladribine (Mavenclad) should be delayed until your symptoms have cleared up.

If you're advised to go to your local hospital by any health professional, or go to hospital for any other reason, you should alert your MS team (even if you are not admitted). If you are taking a DMT they may want to discuss pausing or switching your treatment for the time being.

Can I treat coronavirus COVID-19 with ibuprofen?

The UK government has looked into this and says you can take paracetamol or ibuprofen when self-medicating for symptoms of COVID-19, like fever and headache, and follow NHS advice if they have any questions or if symptoms get worse.

We last updated this page on Friday 20 November

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More information

Go to our MS and coronavirus care and support page

Read the latest research on coronavirus and MS