Kévin Bigaut1, Laurent Kremer2, Thibaut Fabacher2, Livia Lanotte2, Marie-Celine Fleury2, Nicolas Collongues2, Jerome de Seze2. 1. From the Department of Neurology (K.B., L.K., L.L., F.M.-C., N.C., J.S.), Hôpitaux Universitaires de Strasbourg; Clinical Investigation Center (K.B., L.K., N.C., J.S.), Hôpitaux Universitaires de Strasbourg; INSERM 1119 Biopathologie de la Myéline (K.B., L.K., N.C., J.S.), Neuroprotection et Stratégies Thérapeutiques; and Department of Public Health (T.F.), Hôpitaux Universitaires de Strasbourg, France. kevin.bigaut@chru-strasbourg.fr. 2. From the Department of Neurology (K.B., L.K., L.L., F.M.-C., N.C., J.S.), Hôpitaux Universitaires de Strasbourg; Clinical Investigation Center (K.B., L.K., N.C., J.S.), Hôpitaux Universitaires de Strasbourg; INSERM 1119 Biopathologie de la Myéline (K.B., L.K., N.C., J.S.), Neuroprotection et Stratégies Thérapeutiques; and Department of Public Health (T.F.), Hôpitaux Universitaires de Strasbourg, France.
Abstract
OBJECTIVE: To compare the humoral response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with multiple sclerosis (MS) receiving different disease-modifying treatments (DMTs). METHODS: Patients with MS with coronavirus disease 2019 (COVID-19) and available anti-SARS-CoV-2 serology were included. The primary endpoint was the anti-SARS-CoV-2 immunoglobulin G (IgG) index. The multivariate analysis was adjusted for COVID-19 severity, SARS-CoV-2 PCR result, and the time between COVID-19 onset and the serology. RESULTS: We included 61 patients with available IgG index. The IgG index was lower in patients with fingolimod or anti-CD20 monoclonal antibodies compared with patients without treatment (p < 0.01), patients with interferon β-1a or glatiramer (p < 0.01), and patients with another DMT (p = 0.01). The IgG index was correlated with the time between COVID-19 onset and serology (r = -0.296 [-0.510; -0.0477], p = 0.02). CONCLUSIONS: Humoral response after COVID-19 was lower in patients with MS with fingolimod or anti-CD20 mAb. These patients could therefore be at risk of recurrent infection and could benefit from anti-SARS-CoV-2 vaccination. The humoral response after vaccination and the delay before vaccination need to be evaluated. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that patients treated with fingolimod or anti-CD20 monoclonal antibodies for MS have a lower humoral response after COVID-19 compared with patients without DMTs or with another DMTs.
OBJECTIVE: To compare the humoral response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with multiple sclerosis (MS) receiving different disease-modifying treatments (DMTs). METHODS:Patients with MS with coronavirus disease 2019 (COVID-19) and available anti-SARS-CoV-2 serology were included. The primary endpoint was the anti-SARS-CoV-2immunoglobulin G (IgG) index. The multivariate analysis was adjusted for COVID-19 severity, SARS-CoV-2 PCR result, and the time between COVID-19 onset and the serology. RESULTS: We included 61 patients with available IgG index. The IgG index was lower in patients with fingolimod or anti-CD20 monoclonal antibodies compared with patients without treatment (p < 0.01), patients with interferon β-1a or glatiramer (p < 0.01), and patients with another DMT (p = 0.01). The IgG index was correlated with the time between COVID-19 onset and serology (r = -0.296 [-0.510; -0.0477], p = 0.02). CONCLUSIONS: Humoral response after COVID-19 was lower in patients with MS with fingolimod or anti-CD20 mAb. These patients could therefore be at risk of recurrent infection and could benefit from anti-SARS-CoV-2 vaccination. The humoral response after vaccination and the delay before vaccination need to be evaluated. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that patients treated with fingolimod or anti-CD20 monoclonal antibodies for MS have a lower humoral response after COVID-19 compared with patients without DMTs or with another DMTs.
Authors: Z L E van Kempen; L Wieske; E W Stalman; L Y L Kummer; P J van Dam; A G Volkers; L Boekel; A A Toorop; E M M Strijbis; S W Tas; G J Wolbink; M Löwenberg; C van Sandt; A Ten Brinke; N J M Verstegen; M Steenhuis; T W Kuijpers; S M van Ham; T Rispens; F Eftimov; J Killestein Journal: Mult Scler Relat Disord Date: 2021-11-23 Impact factor: 4.339
Authors: Joseph J Sabatino; Kristen Mittl; William M Rowles; Kira McPolin; Jayant V Rajan; Matthew T Laurie; Colin R Zamecnik; Ravi Dandekar; Bonny D Alvarenga; Rita P Loudermilk; Chloe Gerungan; Collin M Spencer; Sharon A Sagan; Danillo G Augusto; Jessa R Alexander; Joseph L DeRisi; Jill A Hollenbach; Michael R Wilson; Scott S Zamvil; Riley Bove Journal: JCI Insight Date: 2022-02-22
Authors: Joseph J Sabatino; Kristen Mittl; William Rowles; Kira Mcpolin; Jayant V Rajan; Colin R Zamecnik; Ravi Dandekar; Bonny D Alvarenga; Rita P Loudermilk; Chloe Gerungan; Collin M Spencer; Sharon A Sagan; Danillo G Augusto; Jessa Alexander; Jill A Hollenbach; Michael R Wilson; Scott S Zamvil; Riley Bove Journal: medRxiv Date: 2021-09-20