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Rath L, Bui MV, Ellis J, Carey J, Baker J, Taylor L, Fernando H, Taylor N, Savage P, Richards J, Zhong M, Kalincik T, Skibina O, Wesselingh R, Nguyen AL, Monif M, Butzkueven H, van der Walt A. Fast and safe: Optimising multiple sclerosis infusions during COVID-19 pandemic. Mult Scler Relat Disord 2020; 47:102642. [PMID: 33321356 PMCID: PMC7955770 DOI: 10.1016/j.msard.2020.102642] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/13/2020] [Accepted: 11/22/2020] [Indexed: 12/29/2022]
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.
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Affiliation(s)
- Louise Rath
- Alfred Health, Clinical Neurosciences, Melbourne, Australia.
| | - Minh Viet Bui
- Alfred Health, Clinical Neurosciences, Melbourne, Australia
| | - Julian Ellis
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
| | - John Carey
- Royal Melbourne Hospital, Melbourne, Australia
| | | | - Lisa Taylor
- Royal Melbourne Hospital, Melbourne, Australia
| | | | | | | | | | - Michael Zhong
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
| | - Tomas Kalincik
- Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Olga Skibina
- Alfred Health, Clinical Neurosciences, Melbourne, Australia
| | - Robb Wesselingh
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
| | - Ai-Lan Nguyen
- Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Mastura Monif
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
| | - Helmut Butzkueven
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
| | - Anneke van der Walt
- Alfred Health, Clinical Neurosciences, Melbourne, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne Australia
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