多发性硬化症患者接种疾病修饰疗法后疫苗接种后突破COVID-19的风险
Ronen Spierer1,2, Idit Lavi3, Sivan Bloch1,2
1Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
接种COVID-19疫苗有效地保护患有多发性硬化症 (pwMS) 的患者. 然而,高效的疾病修饰疗法 (DMT) 如克拉迪宾,奥克雷利祖马布,S1P调节剂和纳塔利祖马布可能会增加突破性感染的风险,尽管感染通常是轻微的.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 多发性硬化症 (MS) 的疾病修饰疗法 (DMT) 可能会影响疫苗的疗效.
- 了解DMT上MS患者 (pwMS) 突破COVID-19的风险至关重要.
研究的目的:
- 调查各种DMT之间的关联以及pwMS中COVID-19突破的风险.
- 评估使用DMT治疗的PWMS患者的COVID-19疫苗接种的有效性.
主要方法:
- 利用以色列克拉利特医疗服务公司的基于人口的数据.
- 在2020年12月至2021年8月的DMT上跟踪pwMS,分析COVID-19感染风险.
- 使用时间依赖的多变量考克斯比例危险模型来估计危险比率.
主要成果:
- 接种疫苗在pwMS中显示出对COVID-19的保护作用 (HR=0.41).
- 完全接种了克拉德里宾,奥克雷利祖马布,S1P受体调节剂和纳塔利祖马布的pwMS,显示出突破性COVID-19风险增加 (HRs从3.3到6.1).
- 接种疫苗的pwMS中COVID-19病例通常是轻微的,仅报告了两个严重的感染.
结论:
- 接种COVID-19疫苗是有效的保护pwMS.
- 高效的DMT与突破性感染的风险更高有关,但结果通常仍然温和.
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