The Washington State Neurological Society (WSNS) is issuing the following position statement with regard to intravenous infusion therapies for patients with neurologic disease in Washington State, issued on October 23, 2015 at the WSNS Annual Meeting.
Intravenous infusion of immune suppressing or immune modifying medications are a powerful tool for several neurologic diseases. Neurologists prescribe such medications for diseases including multiple sclerosis (MS), myasthenia gravis, neuromyelitis optica, myositis, and inflammatory neuropathies (such as Guillain-Barre). Many of these medications have great potential benefit but also significant, sometimes fatal, potential risks. This is especially, and specifically, crucial with infusions of natalizumab. This medication is used to treat MS, and this medication carries a risk for progressive multifocal leukoencephalopathy (PML). PML is a devastating and often fatal condition, and in its early stages the symptoms of PML can mimic the symptoms of MS. For this reason, it is critical that clinical staff administering this medicine be skilled at recognizing signs of PML and able to initiate treatment for it. The WSNS anticipates future medications will likely carry similar risks.
These medications must be administered by professional, licensed clinicians with experience and expertise in the potential risks and side effects of such medications. The WSNS position is that the choice of an Infusion Center for delivery of such medications should be the choice of the treating neurologist and the patient. The choice should be made dictated by patient safety, and an Infusion Center with appropriate experience and expertise with the prescribed medication should be the deciding factor. This choice should not be subject to the concerns of a third party or criteria other than patient safety.
The Washington State Neurological Society represents the neurologists of Washington State. The purpose of the Society is to promote the science and practice of neurology in Washington State; to advocate for neurologists and patients with neurological disorders; and to promote and protect the neurological health of the public.