20.500.12556/DiRROS-30032 A multi-centre longitudinal study analysing multiple sclerosis disease-modifying therapy prescribing patterns during the COVID-19 pandemic Background The COVID-19 pandemic raised concern amongst clinicians that disease-modifying therapies (DMT), particularly anti-CD20 monoclonal antibodies (mAb) and fngolimod, could worsen COVID-19 in people with multiple sclerosis (pwMS). This study aimed to examine DMT prescribing trends pre- and post-pandemic onset. Methods A multi-centre longitudinal study with 8,771 participants from MSBase was conducted. Two time periods were defned: pre-pandemic (March 11 2018–March 10 2020) and post-pandemic onset (March 11 2020–11 March 2022). The association between time and prescribing trends was analysed using multivariable mixed-efects logistic regression. DMT initiation refers to frst initiation of any DMT, whilst DMT switches indicate changing regimen within 6 months of last use. Results Post-pandemic onset, there was a signifcant increase in DMT initiation/switching to natalizumab and cladribine [(Natalizumab-initiation: OR 1.72, 95% CI 1.39–2.13; switching: OR 1.66, 95% CI 1.40–1.98), (Cladribine-initiation: OR 1.43, 95% CI 1.09–1.87; switching: OR 1.67, 95% CI 1.41–1.98)]. Anti-CD20mAb initiation/switching decreased in the year of the pandemic, but recovered in the second year, such that overall odds increased slightly post-pandemic (initiation: OR 1.26, 95% CI 1.06–1.49; Switching: OR 1.15, 95% CI 1.02–1.29. Initiation/switching of fngolimod, interferon-beta, and alemtuzumab signifcantly decreased [(Fingolimod-initiation: OR 0.55, 95% CI 0.41–0.73; switching: OR 0.49, 95% CI 0.41–0.58), (Interferon-gamma-initiation: OR 0.48, 95% CI 0.41–0.57; switching: OR 0.78, 95% CI 0.62–0.99), (Alemtuzumab-initiation: OR 0.27, 95% CI 0.15–0.48; switching: OR 0.27, 95% CI 0.17–0.44)]. Conclusions Post-pandemic onset, clinicians preferentially prescribed natalizumab and cladribine over anti-CD20 mAbs and fngolimod, likely to preserve efcacy but reduce perceived immunosuppressive risks. This could have implications for disease progression in pwMS. Our fndings highlight the signifcance of equitable DMT access globally, and the importance of evidence-based decision-making in global health challenges. multiple sclerosis covid-19 disease-modifying therapy true false true Angleški jezik Ni določen Neznano 2026-06-12 09:54:40 2026-06-12 09:54:41 2026-06-13 03:52:11 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis z dne 22. 10. 2024; str. 5813–5824 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 61 1432-1459 10.1007/s00415-024-12518-7 212551683 RAZ_Lal_Anoushka_P._2024.pdf RAZ_Lal_Anoushka_P._2024.pdf 1 C96396B4F21F438114AC0ACEF2B82D64 0031ca09e077692a661fd7c59270b54a3954aa93fc76f4682850b75cff9856f5 15267e9c-6634-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45287 https://link.springer.com/article/10.1007/s00415-024-12518-7 1 f9f79c6b-6633-11f1-aebd-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=45286 Univerzitetni klinični center Ljubljana 0 0 0