Table 2.
At risk category | Class | Trade Name | Safe to start treatment | Advice regarding treatment | COVID‐19 infection |
---|---|---|---|---|---|
Very low | Interferon‐beta | Betaferon, Avonex, Rebif, Plegridy | Yes | Continue | Continue |
Very low | Glatiramer acetate | Copaxone | Yes | Continue | Continue |
Very low | Cladribine/Alemtuzumab/Mitoxantrone/HSCT | see below | N/A | N/A | N/A |
Very low | Teriflunomide | Aubagio | Yes | Continue | Continue |
Low | Dimethyl fumarate | Tecfidera | Probably | Continue/Switch if lymphopenia | Continue |
Low | Natalizumab (EID) | Tysabri | Yes | Continue | Continue or miss infusion depending on timing |
Low | Anti‐CD20 | Ocrelizumab (Ocrevus), Ofatumumab, Rituximab, Ublituximab | Probably | Risk assessment ‐ continue or suspend dosing | Temporary suspension of dosing depending on timing |
Intermediate | Cladribine | Mavenclad | Probably | Risk assessment ‐ continue or suspend dosing | Temporary suspension of dosing depending on timing |
Intermediate | S1P modulators | Fingolimod (Gilenya), Siponimod (Mazent), Ozanimod, Ponesimod | Probably | Continue | Continue or temporary suspension of dosing |
Intermediate | Natalizumab (SID) | Tysabri | Yes | Continue, but consider EID | Continue or miss infusion depending on timing |
High a | Mitoxantrone | Novatrone | No | Suspend dosing | Suspend dosing |
High a | Alemtuzumab | Lemtrada | No | Suspend dosing | Suspend dosing |
High a | HSCT | – | No | Suspend dosing | Suspend dosing |
Risk refers to acquiring infection during the immunodepletion phase. With postimmune reconstitution, the risk is low.
COVID‐19 = coronavirus disease 2019; EID = extended interval dosing; HSCT = hematopoietic stem‐cell transplant; N/A = not applicable; SID = standard interval dosing.