Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis.
Anti-cd20
Clinical trials
Covid-19
Ocrelizumab
Sars-cov-2
Vaccination
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
24
08
2021
accepted:
01
09
2021
pubmed:
28
9
2021
medline:
17
12
2021
entrez:
27
9
2021
Statut:
ppublish
Résumé
The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy. To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS). IgG Abs against SARS-CoV-2 spike receptor-binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60). 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine. Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.
Sections du résumé
BACKGROUND
BACKGROUND
The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy.
OBJECTIVE
OBJECTIVE
To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS).
METHOD
METHODS
IgG Abs against SARS-CoV-2 spike receptor-binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60).
RESULTS
RESULTS
36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine.
CONCLUSION
CONCLUSIONS
Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.
Identifiants
pubmed: 34571415
pii: S2211-0348(21)00518-6
doi: 10.1016/j.msard.2021.103251
pmc: PMC8426319
pii:
doi:
Substances chimiques
Antibodies, Viral
0
COVID-19 Vaccines
0
RNA, Messenger
0
BNT162 Vaccine
N38TVC63NU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103251Subventions
Organisme : NINDS NIH HHS
ID : K08 NS096117
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI131624
Pays : United States
Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
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