Breakthrough SARS-CoV-2 infections in MS patients on disease-modifying therapies.


Journal

Multiple sclerosis (Houndmills, Basingstoke, England)
ISSN: 1477-0970
Titre abrégé: Mult Scler
Pays: England
ID NLM: 9509185

Informations de publication

Date de publication:
Nov 2022
Historique:
pubmed: 24 6 2022
medline: 19 10 2022
entrez: 23 6 2022
Statut: ppublish

Résumé

Patients with multiple sclerosis (pwMS) treated with anti-CD20 or fingolimod showed a reduced humoral response to SARS-CoV-2 vaccines. In this study we aimed to monitor the risk of breakthrough SARS-CoV-2 infection in pwMS on different disease-modifying therapies (DMTs). Data on the number of vaccinated patients and the number of patients with a breakthrough infection were retrospectively collected in 27 Italian MS centers. We estimated the rate of breakthrough infections and of infection requiring hospitalization per DMT. 19,641 vaccinated pwMS were included in the database. After a median follow-up of 8 months, we observed 137 breakthrough infections. Compared with other DMTs, the rate of breakthrough infections was significantly higher on ocrelizumab (0.57% vs 2.00%, risk ratio (RR) = 3.55, 95% CI = 2.74-4.58, The risk of breakthrough SARS-CoV-2 infections is higher in patients treated with ocrelizumab and fingolimod, and the rate of severe infections was significantly reduced in all the DMTs excluding ocrelizumab.

Sections du résumé

BACKGROUND
Patients with multiple sclerosis (pwMS) treated with anti-CD20 or fingolimod showed a reduced humoral response to SARS-CoV-2 vaccines.
OBJECTIVE
In this study we aimed to monitor the risk of breakthrough SARS-CoV-2 infection in pwMS on different disease-modifying therapies (DMTs).
METHODS
Data on the number of vaccinated patients and the number of patients with a breakthrough infection were retrospectively collected in 27 Italian MS centers. We estimated the rate of breakthrough infections and of infection requiring hospitalization per DMT.
RESULTS
19,641 vaccinated pwMS were included in the database. After a median follow-up of 8 months, we observed 137 breakthrough infections. Compared with other DMTs, the rate of breakthrough infections was significantly higher on ocrelizumab (0.57% vs 2.00%, risk ratio (RR) = 3.55, 95% CI = 2.74-4.58,
CONCLUSIONS
The risk of breakthrough SARS-CoV-2 infections is higher in patients treated with ocrelizumab and fingolimod, and the rate of severe infections was significantly reduced in all the DMTs excluding ocrelizumab.

Identifiants

pubmed: 35735030
doi: 10.1177/13524585221102918
doi:

Substances chimiques

COVID-19 Vaccines 0
Fingolimod Hydrochloride G926EC510T

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2106-2111

Auteurs

Irene Schiavetti (I)

Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy.

Cinzia Cordioli (C)

Centro Sclerosi Multipla ASST Spedali Civili di Brescia, Montichiari, Italy.

Maria Laura Stromillo (ML)

Clinica Neurologica e Malattie Neurometaboliche, Università degli Studi di Siena, Siena, Italy.

Maria Teresa Ferrò (M)

Neuroimmunology, Center for Multiple Sclerosis, Cardiocerebrovascular Department, Neurological Unit, ASST Crema, Crema, Italy.

Alice Laroni (A)

IRCCS Ospedale Policlinico San Martino, Genova, Italy/Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.

Eleonora Cocco (E)

Centro Sclerosi Multipla Ospedale Binaghi, Cagliari, Italy.

Gaia Cola (G)

Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy.

Livia Pasquali (L)

Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.

Maria Teresa Rilla (MT)

Department of Neurology, Imperia Hospital, Imperia, Italy.

Elisabetta Signoriello (E)

II Division of Neurology, University of Campania Luigi Vanvitelli, Naples, Italy.

Rosa Iodice (R)

Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy.

Alessia Di Sapio (A)

Department of Neurology, Regina Montis Regalis Hospital, Mondovì, Italy.

Roberta Lanzillo (R)

University of Naples Federico II, Naples, Italy.

Francesca Caleri (F)

Department of Neurology, MS Center, F. Tappeiner Hospital, Merano, Italy.

Pietro Annovazzi (P)

UOC Centro Sclerosi Multipla, ASST Valle-Olona, PO di Gallarate (VA), Varese, Italy.

Antonella Conte (A)

Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy.

Giuseppe Liberatore (G)

Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.

Francesca Ruscica (F)

UOC Neurologia e Centro SM Fondazione Istituto G. Giglio, Cefalù, Italy.

Renato Docimo (R)

Multiple Sclerosis Center, Aversa Hospital "San Giuseppe Moscati", ASL Caserta, Aversa, Italy.

Simona Bonavita (S)

Dipartimento di Scienze Mediche e Chirurgiche avanzate, Università degli studi della Campania Luigi Vanvitelli, Naples, Italy.

Monica Ulivelli (M)

Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.

Paola Cavalla (P)

Multiple Sclerosis Center and 1st Division of Neurology, Department of Neuroscience, City of Health and Science University Hospital of Turin, Turin, Italy.

Francesco Patti (F)

Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," University of Catania, Catania, Italy.

Diana Ferraro (D)

Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.

Marinella Clerico (M)

Clinical and Biological Sciences Department, University of Turin, Turin, Italy.

Paolo Immovilli (P)

Guglielmo da Saliceto Hospital, Piacenza, Itlay.

Massimiliano Di Filippo (M)

Department of Medicine and Surgery, Section of Neurology, University of Perugia, Perugia, Italy.

Marco Salvetti (M)

Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy/IRCCS Neuromed, Pozzilli, Italy.

Maria Pia Sormani (MP)

Department of Health Sciences, Section of Biostatistics, University of Genova, Genova, Italy/IRCCS Ospedale Policlinico San Martino, Genova, Italy.

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Classifications MeSH