COVID-19 Vaccine Response in People with Multiple Sclerosis

被引：114

作者：

Tallantyre, Emma C. ^{[1
,2
]}

Vickaryous, Nicola ^{[3
]}

Anderson, Valerie ^{[1
]}

Asardag, Aliye Nazli ^{[4
]}

Baker, David ^{[4
]}

Bestwick, Jonathan ^{[3
]}

Bramhall, Kath ^{[5
]}

Chance, Randy ^{[4
,6
]}

Evangelou, Nikos ^{[7
]}

George, Katila ^{[3
]}

Giovannoni, Gavin ^{[3
,4
,8
]}

Godkin, Andrew ^{[9
,10
]}

Grant, Leanne ^{[5
]}

Harding, Katharine E. ^{[11
]}

Hibbert, Aimee ^{[7
]}

Ingram, Gillian ^{[12
]}

Jones, Meleri ^{[4
]}

Kang, Angray S. ^{[4
,6
]}

Loveless, Samantha ^{[1
]}

Moat, Stuart J. ^{[13
,14
]}

Robertson, Neil P. ^{[1
,2
]}

Schmierer, Klaus ^{[4
,8
]}

Scurr, Martin J. ^{[9
,15
]}

Shah, Sita Navin ^{[3
]}

Simmons, Jessica ^{[1
]}

Upcott, Matthew ^{[1
]}

Willis, Mark ^{[2
]}

Jolles, Stephen ^{[5
,9
]}

Dobson, Ruth ^{[3
,8
]}

机构：

[1] Cardiff Univ, Sch Med, Div Psychol Med & Clin Neurosci, Cardiff, Wales

[2] Univ Hosp Wales, Dept Neurol, Cardiff, Wales

[3] Queen Mary Univ London, Wolfson Inst Populat Hlth, Prevent Neurol Unit, London, England

[4] Queen Mary Univ London, Barts & London Sch Med & Dent, Blizard Inst, London, England

[5] Univ Hosp Wales, Immunodeficiency Ctr Wales, Cardiff, Wales

[6] Queen Mary Univ London, Ctr Oral Immunobiol & Regenerat Med, Barts & London Sch Med & Dent, London, England

[7] Univ Nottingham, Dept Clin Neurol, Nottingham, England

[8] Barts Hlth NHS Trust, Dept Neurol, London, England

[9] Cardiff Univ, Sch Med, Div Infect & Immun, Cardiff, Wales

[10] Univ Hosp Wales, Dept Gastroenterol & Hepatol, Cardiff, Wales

[11] Royal Gwent Hosp, Dept Neurol, Newport, Shrops, England

[12] Morriston Hosp, Dept Neurol, Swansea, W Glam, Wales

[13] Univ Hosp Wales, Dept Med Biochem Immunol & Toxicol, Wales Newborn Screening Lab, Cardiff, Wales

[14] Cardiff Univ, Sch Med, Cardiff, Wales

[15] ImmunoServ Ltd, Cardiff, Wales

来源：

ANNALS OF NEUROLOGY | 2022年 / 91卷 / 01期

关键词：

SARS-COV-2; INFECTION; FINGOLIMOD; BNT162B2;

D O I：

10.1002/ana.26251

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective The purpose of this study was to investigate the effect of disease modifying therapies on immune response to severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines in people with multiple sclerosis (MS). Methods Four hundred seventy-three people with MS provided one or more dried blood spot samples. Information about coronavirus disease 2019 (COVID-19) and vaccine history, medical, and drug history were extracted from questionnaires and medical records. Dried blood spots were eluted and tested for antibodies to SARS-CoV-2. Antibody titers were partitioned into tertiles with people on no disease modifying therapy as a reference. We calculated the odds ratio of seroconversion (univariate logistic regression) and compared quantitative vaccine response (Kruskal Wallis) following the SARS-CoV-2 vaccine according to disease modifying therapy. We used regression modeling to explore the effect of vaccine timing, treatment duration, age, vaccine type, and lymphocyte count on vaccine response. Results Compared to no disease modifying therapy, the use of anti-CD20 monoclonal antibodies (odds ratio = 0.03, 95% confidence interval [CI] = 0.01-0.06, p < 0.001) and fingolimod (odds ratio = 0.04; 95% CI = 0.01-0.12) were associated with lower seroconversion following the SARS-CoV-2 vaccine. All other drugs did not differ significantly from the untreated cohort. Both time since last anti-CD20 treatment and total time on treatment were significantly associated with the response to the vaccination. The vaccine type significantly predicted seroconversion, but not in those on anti-CD20 medications. Preliminary data on cellular T-cell immunity showed 40% of seronegative subjects had measurable anti-SARS-CoV-2 T cell responses. Interpretation Some disease modifying therapies convey risk of attenuated serological response to SARS-CoV-2 vaccination in people with MS. We provide recommendations for the practical management of this patient group. ANN NEUROL 2021

引用

页码：89 / 100

页数：12

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