University Hospital Careggi, Florence, Italy.
Department of Neurofarba, University of Florence, Florence, Italy.
Mult Scler. 2022 Jan;28(1):132-138. doi: 10.1177/13524585211005339. Epub 2021 Mar 25.
The spread of Coronavirus disease-19 (COVID-19) poses unique challenges in the management of people with multiple sclerosis (PwMS).
To collect data about the impact of COVID-19 emergency on access to care for PwMS and on MS treatment practices.
Between March and July 2020, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) promoted an online survey covering patient access to care, management of relapses and visits, disease-modifying therapy (DMT) and experience with COVID-19.
Three-hundred and sixty neurologists from 52 countries (68% from Europe) completed the survey. 98% reported COVID-19-related restrictions. Telemedicine was adopted to overcome the limited access to care and was newly activated (73%) or widely implemented (17%). 70% reported changes in DMT management. Interferons and glatiramer were considered safe. Dimethyl fumarate, teriflunomide and fingolimod were considered safe except for patients developing lymphopenia. No modifications were considered for natalizumab in 64%, cladribine in 24%, anti-CD20 in 22% and alemtuzumab in 17%; 18% (for alemtuzumab and cladribine) and 43% (for anti-CD20) considered postponing treatment.
The ECTRIMS survey highlighted the challenges in keeping standards of care in clinical practice. Telemedicine clearly needs to be implemented. Gathering data on DMT safety will remain crucial to inform treatment decisions.
COVID-19 的传播给多发性硬化症患者（PwMS）的管理带来了独特的挑战。
收集有关 COVID-19 紧急情况对 PwMS 获得护理的影响以及对 MS 治疗实践的影响的数据。
在 2020 年 3 月至 7 月期间，欧洲多发性硬化症治疗与研究委员会（ECTRIMS）开展了一项在线调查，涵盖了患者获得护理、复发和就诊管理、疾病修正治疗（DMT）以及 COVID-19 经历等方面。
来自 52 个国家的 360 名神经病学家（68%来自欧洲）完成了这项调查。98%的受访者报告称存在与 COVID-19 相关的限制。为克服有限的护理机会，采用了远程医疗，新启用（73%）或广泛实施（17%）。70%的受访者报告称 DMT 管理发生了变化。干扰素和格拉替雷被认为是安全的。二甲基富马酸、特立氟胺和芬戈莫德被认为是安全的，除了淋巴细胞减少症患者。64%的受访者认为纳他珠单抗无需调整，24%的受访者认为克拉屈滨无需调整，22%的受访者认为抗 CD20 无需调整，17%的受访者认为阿仑单抗无需调整；18%（阿仑单抗和克拉屈滨）和 43%（抗 CD20）的受访者认为需要推迟治疗。
ECTRIMS 的调查强调了在临床实践中保持护理标准的挑战。远程医疗显然需要实施。收集关于 DMT 安全性的数据对于告知治疗决策仍然至关重要。
