From: A comprehensive review of COVID-19 symptoms and treatments in the setting of autoimmune diseases
Type of DMT | The mechanism of action | Indication of DMT initiation and maintenance during COVID-19 pandemic | References |
---|---|---|---|
Interferon-Beta (INF-β) | T-cell proliferation and leukocyte migration across the blood-brain barrier (BBB) are inhibited by the down-regulation of MHC expression on the APCs and the suppression of pro-inflammatory cytokines | Can be implemented. If influenza-like symptoms reoccur, it should be discontinued until a definite diagnosis can be made | |
Glatiramer Acetate | Transforms inflammatory T-helper-1 cells into regulatory T-helper-2 cells | Can be implemented. Systemic risk of infection is not increased when using this medication | |
Teriflunomide | Inhibition of cytostatic effects by reversible and selective targeting of T and B cells | Can be implemented. Should be discontinued in COVID-19 confirmed cases | [45] |
Dimethyl Furmarate (DMF) | Reduction of pro-inflammatory cytokines and lymphocyte entry into the CNS | Can be implemented. Should be discontinued in COVID-19 confirmed cases | [45] |
Fingolimid | Isolation of lymphocytes in secondary lymphoid tissues | Not indicated. It is associated to an increased risk of infection | |
Natalizumab (NTZ) | Compromising immune supervision only in the CNS by preventing the active lymphocyte trafficking through the blood-brain barrier | It can be initiated and maintained if patients are not infected by COVID-19. Should be discontinued in COVID-19 confirmed patients | [45] |
Cladribine | Optional reduction of CD19 + B lymphocytes and T lymphocytes | Not indicated | |
Rituximab | Cellular cytolysis of CD20-expressing B lymphocytes via a selective connection to these cells, and activating complement mediated cell lysis | Not indicated | |
Ocrelizumab | Cellular cytolysis of CD20-expressing B lymphocytes via selectively connecting to these cells, and the activation of complement mediated cell lysis | Not indicated | [45] |
Alemtuzumab (AMZ) | Induction of T and B cell depletion through antibody-dependent cellular cytotoxicity | Not indicated | [45] |