Association of Disease-Modifying Treatment and Anti-CD20 Infusion Timing With Humoral Response to 2 SARS-CoV-2 Vaccines in Patients With Multiple Sclerosis | Demyelinating Disorders | JN Learning | AMA Ed Hub [Skip to Content]
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Association of Disease-Modifying Treatment and Anti-CD20 Infusion Timing With Humoral Response to 2 SARS-CoV-2 Vaccines in Patients With Multiple Sclerosis

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Studies have shown the messenger RNA (mRNA) vaccine against SARS-CoV-2 is safe in multiple sclerosis (MS), but the humoral response to the vaccine was markedly reduced in patients treated with fingolimod and ocrelizumab.1 We aimed to replicate these findings, test other disease-modifying treatments (DMTs), and investigate whether delaying anti-CD20 infusions can potentiate IgG production following vaccination.

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Article Information

Accepted for Publication: August 24, 2021.

Published Online: September 23, 2021. doi:10.1001/jamaneurol.2021.3609

Corresponding Author: Claudio Gobbi, MD, Multiple Sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland (NSI), Ospedale Civico, Via Tesserete 46, 6900 Lugano, Switzerland (claudio.gobbi@eoc.ch).

Author Contributions: Drs Disanto and Gobbi had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Gobbi and Zecca contributed equally to the manuscript.

Concept and design: Disanto, Gobbi, Zecca.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Disanto, Gobbi.

Critical revision of the manuscript for important intellectual content: Sacco, Bernasconi, Martinetti, Keller, Gobbi, Zecca.

Statistical analysis: Disanto.

Administrative, technical, or material support: Disanto, Sacco, Zecca.

Supervision: Gobbi, Zecca.

Conflict of Interest Disclosures: Dr Bernasconi received fees for his participation on advisory boards and travel grants from Gilead Sciences, MSD, ViiV Healthcare, AbbVie, and Pfizer. Dr Gobbi received research grants or honoraria for speaking and consulting fees from Almirall, Biogen, Celgene, Merck, Novartis, Roche, Sanofi Genzyme, Teva Pharma. Dr Zecca received research grants or honoraria for speaking and consulting fees from Almirall, Biogen, Celgene, Lilly, Lundbeck, Merck, Novartis, Roche, Sanofi, Teva Pharma. No other disclosures were reported.

Funding/Support: This study was supported by institutional funds of the Neurocenter of Southern Switzerland.

Role of the Funder/Sponsor: The Neurocenter of Southern Switzerland had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Achiron  A , Mandel  M , Dreyer-Alster  S ,  et al.  Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies.   Ther Adv Neurol Disord. 2021;14:17562864211012835. doi:10.1177/17562864211012835PubMedGoogle Scholar
2.
Baden  LR , El Sahly  HM , Essink  B ,  et al; COVE Study Group.  Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine.   N Engl J Med. 2021;384(5):403-416. doi:10.1056/NEJMoa2035389PubMedGoogle ScholarCrossref
3.
Polack  FP , Thomas  SJ , Kitchin  N ,  et al; C4591001 Clinical Trial Group.  Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine.   N Engl J Med. 2020;383(27):2603-2615. doi:10.1056/NEJMoa2034577PubMedGoogle ScholarCrossref
4.
Maine  GN , Lao  KM , Krishnan  SM ,  et al.  Longitudinal characterization of the IgM and IgG humoral response in symptomatic COVID-19 patients using the Abbott Architect.   J Clin Virol. 2020;133:104663. doi:10.1016/j.jcv.2020.104663PubMedGoogle Scholar
5.
Boremalm  M , Sundström  P , Salzer  J .  Discontinuation and dose reduction of rituximab in relapsing-remitting multiple sclerosis.   J Neurol. 2021;268(6):2161-2168. doi:10.1007/s00415-021-10399-8PubMedGoogle ScholarCrossref
6.
Low  JS , Vaqueirinho  D , Mele  F ,  et al.  Clonal analysis of immunodominance and cross-reactivity of the CD4 T cell response to SARS-CoV-2.   Science. 2021;372(6548):1336-1341. doi:10.1126/science.abg8985PubMedGoogle ScholarCrossref
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