Q&A with your MS pharmacist about DMTs

Questions answered

• 0:36 – What have you observed and experienced, what would you highlight that has made you proud of the neuro-pharmacist response to the crises?
• 5:13 – Infusion capacity is a problem in many centres, how are you prioritising patients to be treated. What role can pharmacy play in this?
• 7:07 – Hospital at home service: what drugs are you looking at and how does it work?
• 12:29 – Looking at the treatment interval for natalizumab: how and when should we revert back to 4 weekly infusions?
• 19:02 – Is it ok to resume ocrelizumab infusions for existing patients and are there any additional checks we need to perform prior to this? And when is it safe to start new patients?
• 21:32 – How are you identifying those patients suitable for faster ocrelizumab rates?
• 25:38 – Ocrelizumab in PPMS: do you think COVID-19 has had an impact?
• 27:50 – Are you updating all of your DMT protocols in light of COVID-19 and the upcoming vaccines?
• 28:55 – Shielding & risks for patients
• 31:41 – Alemtuzumab therapy: one of my patients had their first course in March 2019, due for second in March 2020 which was delayed due to pandemic. I noticed the WCC (around 3) and lymphocyte count (0.7) was not completely reconstituted. We are aiming to provide the second course in August 2020. Current WCC 2.3 and LC 0.8. Should we wait for the pandemic threat level to drop to below 2 before the second course or can we schedule the second course with a maximum delay of 6 months with post infusion precautions of self isolation for 12 weeks?
• 37:50 – The role of the pharmacist during this time + 57:08
• 39:38 – Siponimod was due the NICE technology appraisal and the date has been extended. How many patients do you think will be treated with Siponimod and does it pose any challenges you foresee?
• 46:29 – Blueteq: Does natalizumab need more than one blueteq form ongoing?
• 48:15 – Is it necessary the patients with low titles of IgG antibodies against VZV to be vaccinated before the beginning of treatment?
• 51:55 – Patient query: My husband was diagnosed with MS 5 years ago. Being previously on Plegridy was no benefit. Commenced Ocrevus in December last year. Due his second dose in June this year. We would both like this to go ahead if possible. Could you please tell me your thoughts on this?
• 54:55 – Vaccinations

ABN guidance on the use of DMTs in MS

• theabn.org/page/COVID-19
• Starting the Restart: ABN Guidance on recommencing neurology services in the recovery phase of the COVID-19 pandemic (20/05/2020)
• MS DMT drug guidance (18/05/2020)

UK Government links

• Register a clinically extremely vulnerable person for support
• The UK Government’s COVID-19 recovery strategy

MS charities

• MS Society: mssociety.org.uk/care-and-support/ms-and-coronavirus-care-and-support
• MS Trust
  • mstrust.org.uk/a-z/coronavirus-covid-19-and-multiple-sclerosis
  • Information for health professionals

Our Multiple Sclerosis webinars are available on SoundCloud:
soundcloud.com/neurologyacademy