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Anti-CD20 therapies decrease humoral immune response to SARS-CoV-2 in patients with multiple sclerosis or
Céline Louapre1, Michella Ibrahim2, Elisabeth Maillart2
1Sorbonne University, Paris Brain Institute - ICM, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, CIC neurosciences, Department of Neurology, Hôpital de la Pitié-Salpêtrière, Paris, France celine.louapre@aphp.fr.
Journal of Neurology, Neurosurgery, and Psychiatry
|August 3, 2021
Summary
Patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMO-SD) on anti-CD20 therapies showed a significantly reduced SARS-CoV-2 antibody response after COVID-19 infection. This highlights the need for careful monitoring and tailored vaccination strategies in this vulnerable group.
Area of Science:
- Immunology
- Neurology
- Infectious Diseases
Background:
- Disease-modifying therapies (DMTs) may impact SARS-CoV-2 seroconversion rates in patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMO-SD).
- Understanding antibody response is crucial for managing COVID-19 in these patient populations.
Purpose of the Study:
- To investigate SARS-CoV-2 antibody seroprevalence and levels in patients with MS or NMO-SD.
- To assess the influence of different DMTs on serological outcomes post-COVID-19.
Main Methods:
- Analysis of blood samples from 119 patients diagnosed with COVID-19.
- Comparison of SARS-CoV-2 antibody positivity rates and immunoglobulin (Ig) levels across various DMT groups.
- Utilized multivariate logistic and linear regression to determine DMT influence on serological outcomes.
Main Results:
- Overall seroconversion rate was 80.6% within 5 months post-infection.
- Patients on anti-CD20 therapies exhibited significantly lower SARS-CoV-2 Ig positivity (47.6%) compared to those on other DMTs (85.7%) or no DMTs (95.2%).
- Anti-CD20 treatment was independently associated with decreased odds of positive serology (OR, 0.07; p=0.02).
Conclusions:
- SARS-CoV-2 antibody response is diminished in MS and NMO-SD patients treated with anti-CD20 therapies.
- Long-term monitoring for reinfection risk and development of specific vaccination strategies are recommended for this cohort.
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