Table 2.

Proposed Revised Guidelines

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.