Central American and Caribbean Consensus for the Treatment of Multiple Sclerosis and Therapeutic Attitudes Facing the COVID-19 Pandemic

Alejandro Díaz (1) , Fernando Gracia (2) , Priscilla Monterrey-Alvarez (3) , Adda V. Sirias Baca (4) , Biany Santos (5) , Temis Enamorado (6) , Johana Vásquez-Céspedes (7) , Alexander Parajeles-Vindas (8) , Deyanira Ramírez-Navarro (9) , Amado Díaz de la Fe (10) , Ligia Portillo-Rivera (11) , Nidia Eunice Ramíres (12) , Victor M. Rivera (13)
(1) a:1:{s:5:"en_US";s:36:"Guatemalan Social Security Institute";} , Guatemala
(2) Santo Tomás Hospital, Interamerican University of Panama , Panama
(3) Costa Rican Social Security Institute , Costa Rica
(4) Hospital San Felipe, Tegucigalpa. , Honduras
(5) José María Cabral and Báez Regional University Hospital , Dominican Republic
(6) Honduran Social Security Institute. Tegucigalpa , Honduras
(7) Costa Rican Social Security Institute , Costa Rica
(8) Costa Rican Social Security Institute , Costa Rica
(9) Multiple Sclerosis Unit, Padre Billini Teaching Hospital , Costa Rica
(10) International Centre for Neurologic Restoration (CIREN), La Habana , Cuba
(11) Guatemalan Social Security Institute , Guatemala
(12) Mario Catarino Rivas Hospital. San Pedro Sula , Honduras
(13) Baylor College of Medicine. Houston, Texas , United States

Abstract

Therapeutic decisions for multiple sclerosis have become more complex in the Central American and Caribbean region (CAC), with new treatments appearing every year but with well-known limitations in terms of access and application. Concomitantly, the advent of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, with an increasing number of cases in the region, has increased the need for a consensus on therapeutic decisions to be made for people with multiple sclerosis. Under these circumstances, a reference framework is needed to gather current information to assist neurologists in making therapeutic decisions.


An evidence-based consensus on the use of disease-modifying therapies for multiple sclerosis was proposed and accomplished by the Central American and Caribbean Multiple Sclerosis Forum (FOCEM), including recommendations for treatment during the pandemic. Using the consensus panel development methodology, after a bibliographic review of the best quality and actualized information, a final report was written; this includes statements that reached more than 70% consensus among the panel of experts.


The recommendations encompass indications for drugs available for multiple sclerosis, definitions of therapeutic failure, patient follow-up, factors of poor prognosis, discontinuation of treatment, treatment during pregnancy and lactation and specific recommendations to apply during the SARS-CoV-2 pandemic.

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Authors

Alejandro Díaz
ajdj1978@gmail.com (Primary Contact)
Fernando Gracia
Priscilla Monterrey-Alvarez
Adda V. Sirias Baca
Biany Santos
Temis Enamorado
Johana Vásquez-Céspedes
Alexander Parajeles-Vindas
Deyanira Ramírez-Navarro
Amado Díaz de la Fe
Ligia Portillo-Rivera
Nidia Eunice Ramíres
Victor M. Rivera
Díaz, A., Gracia, F., Monterrey-Alvarez, P., Sirias Baca, A. V., Santos, B., Enamorado, T., Vásquez-Céspedes, J., Parajeles-Vindas, A., Ramírez-Navarro, D., Díaz de la Fe, A., Portillo-Rivera, L., Ramíres, N. E., & Rivera, V. M. (2020). Central American and Caribbean Consensus for the Treatment of Multiple Sclerosis and Therapeutic Attitudes Facing the COVID-19 Pandemic. Journal of Current Medical Research and Opinion, 3(09). https://doi.org/10.15520/jcmro.v3i09.338
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