Attenuation of antibody response to SARS-CoV-2 infection in patients with multiple sclerosis on ocrelizumab: A case-control study
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1Comprehensive MS Center, Methodist Hospitals, Merrillville IN 46410, USA.
Objective:
Ocrelizumab (OCR) is a monoclonal antibody directed at B-cells that is FDA approved for treatment of RRMS and PPMS. Prior studies have raised concerns about patients' ability to form antibodies in response to various antigens, especially SARS-CoV-2. The objective of this study is to determine whether OCR attenuates the antibody response to SARS-CoV-2 in patients with MS as compared with other disease modifying therapies.
Methods:
This is a case-control study looking at the odds of developing antibodies to SARS-CoV-2 in patients treated with OCR versus other disease modifying therapies. From May 13, 2020 through March 1, 2021, patients with a RT-PCR-confirmed infection to SARS-CoV-2 were tested for presence of antibodies and the data was recorded. Outpatients with MS at the Methodist Hospitals Comprehensive MS Center were selected who had a prior infection with COVID-19 as demonstrated by RT-PCR in the electronic health records. Odds ratios were calculated to compare rates of antibody formation with OCR exposure vs other DMT.
Results:
24 patients had evidence of COVID-19 and had antibody testing available at the time of analysis. Patients who received OCR had decreased odds of forming antibodies (OR 0.045, p = 0.011, 95% CI (0.004,0.488)).
Conclusions:
Patients who received OCR within the prior 6 months of COVID-19 infection had decreased odds of developing antibodies as compared with other DMTs. This suggests that OCR may attenuate the antibody response to SARS-CoV-2. Additional studies should analyze the odds of spike protein antibody formation in response to SARS-CoV-2 vaccines for patients on OCR.
Insights
Ocrelizumab (OCR) treatment in MS patients may reduce antibody formation against SARS-CoV-2. This study found significantly decreased odds of antibody development in patients treated with OCR compared to other therapies.
Area of Science:
- Immunology
- Neurology
- Infectious Diseases
Background:
- Ocrelizumab (OCR) is an FDA-approved B-cell depleting therapy for relapsing and primary progressive multiple sclerosis (MS).
- Concerns exist regarding OCR's impact on antibody responses to infections, including SARS-CoV-2.
Purpose of the Study:
- To investigate if Ocrelizumab (OCR) treatment attenuates the antibody response to SARS-CoV-2 in patients with multiple sclerosis (MS).
- To compare antibody formation rates in MS patients treated with OCR versus other disease-modifying therapies (DMTs) after SARS-CoV-2 infection.
Main Methods:
- A case-control study design was employed.
- Patients with RT-PCR confirmed SARS-CoV-2 infection and available antibody testing were analyzed.
- Odds ratios were calculated to compare antibody formation rates between OCR-treated and other DMT-treated MS patients.
Main Results:
- Twenty-four patients with confirmed COVID-19 and available antibody data were included.
- Patients treated with Ocrelizumab (OCR) showed significantly decreased odds of forming antibodies to SARS-CoV-2 (OR 0.045, p=0.011).
Conclusions:
- Ocrelizumab (OCR) treatment within six months of SARS-CoV-2 infection was associated with reduced antibody development compared to other DMTs.
- These findings suggest Ocrelizumab may attenuate the antibody response to SARS-CoV-2.
- Further research is recommended to assess antibody responses to SARS-CoV-2 vaccines in patients receiving OCR.
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