Original article
Fast and safe: Optimising multiple sclerosis infusions during COVID-19 pandemic

https://doi.org/10.1016/j.msard.2020.102642Get rights and content

Highlights

  • The COVID-19 pandemic required swift strategic planning to ensure ongoing access to the initiation and continuance of infusible treatments for people with multiple sclerosis

  • Rapid infusions of natalizumab and ocrelizumab in our cohort was not associated with an increased incidence of infusion related reactions compared to incidence of infusion reactions in pivotal trials.

  • Rapid infusion protocols led to more efficient use of infusion centre resources with overall booking times reduced

  • Acute clinical observation after the completion of the infusion may not be warranted given no major safety concerns were raised

Abstract

Background: The COVID-19 pandemic challenges multiple sclerosis services to be innovative in delivering infusible therapies. To reduce time in clinical settings, and potential staff or space losses, we implemented rapid infusion protocols for selected patients.

Objective: To analyse the rate of infusion related reactions and patient experience of rapid infusions of natalizumab and ocrelizumab. To document time reduction patients spent in clinical settings during the COVID-19 pandemic.

Methods: Patients with prior exposure to at least three natalizumab or two 300mg ocrelizumab infusions were approved for rapid protocols. A retrospective audit and survey were completed.

Results: We analysed 269 rapid natalizumab infusions and 100 rapid ocrelizumab infusions. Infusion related reactions during the natalizumab or ocrelizumab infusions occurred in two patients (1.52%) and eight patients (8%), respectively. All infusion related reactions were mild to moderate and did not require infusion discontinuation. No infusion reactions occurred during the post-infusion observation. Patient experience was positive.

Conclusion: Frequency or severity of infusion related reactions in rapid infusions were no different compared to published data. In the setting of COVID-19, pandemic rapid infusion protocols could potentially save hospital resources and limit patient exposure to a high-risk clinical setting while still maintaining ongoing treatment of multiple sclerosis.

Keywords

Multiple Sclerosis
COVID-19 pandemic
resource utilisation
infusion related reactions
rapid infusions
natalizumab
ocrelizumab
post observational time

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