Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis

Frederik Novak; Anna Christine Nilsson; Christian Nielsen; Dorte K. Holm; Kamilla Østergaard; Anna Bystrup; Keld Erik Byg; Isik S. Johansen; Kristen Mittl; William Rowles; Kira Mcpolin; Collin Spencer; Sharon Sagan; Chloe Gerungan; Michael R. Wilson; Scott S. Zamvil; Riley Bove; Joseph J. Sabatino; Tobias Sejbaek

doi:10.1016/j.msard.2021.103251

Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis

Frederik Novak, Anna Christine Nilsson, Christian Nielsen, Dorte K. Holm, Kamilla Østergaard, Anna Bystrup, Keld Erik Byg, Isik S. Johansen, Kristen Mittl, William Rowles, Kira Mcpolin, Collin Spencer, Sharon Sagan, Chloe Gerungan, Michael R. Wilson, Scott S. Zamvil, Riley Bove, Joseph J. Sabatino, Tobias Sejbaek^*

^*Kontaktforfatter

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

17 Downloads (Pure)

Abstrakt

Background: The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy. Objective: To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS). Method: IgG Abs against SARS-CoV-2 spike receptor–binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60). Results: 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine. Conclusion: Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.

Originalsprog	Engelsk
Artikelnummer	103251
Tidsskrift	Multiple Sclerosis and Related Disorders
Vol/bind	56
Antal sider	5
ISSN	2211-0348
DOI	https://doi.org/10.1016/j.msard.2021.103251
Status	Udgivet - nov. 2021

Bibliografisk note

Funding Information:
We acknowledge the great help received from patients participating in this trial and our team of technicians and study coordinators represented by Gunhild Brixen (Sormani et al. 2021) Nielsen, Rikke Bjerre Rosengren (Sormani et al. 2021) and Pia Hannesbo (Khoury et al. 2021). We acknowledge grants given by the Lundbeck Neurological Scholarship delegated by Danish Neurological Society and by Region of Southern Denmark.

Funding Information:
T Sejbaek has received travel grants from Biogen, Merck, Novartis and Roche, has received research grants from Biogen and has served on advisory boards for Biogen and Novartis.

Funding Information:
M Wilson has received research grant funding from Roche/Genentech and speaking honoraria from Novartis, Takeda and Genentech.

Dokumenter og links

10.1016/j.msard.2021.103251Licens: CC BY

Open Access VersionForlagets udgivne version, 628 KBLicens: CC BY

Citationsformater

Novak, F., Nilsson, A. C., Nielsen, C., Holm, D. K., Østergaard, K., Bystrup, A., Byg, K. E., Johansen, I. S., Mittl, K., Rowles, W., Mcpolin, K., Spencer, C., Sagan, S., Gerungan, C., Wilson, M. R., Zamvil, S. S., Bove, R., Sabatino, J. J., & Sejbaek, T. (2021). Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis. Multiple Sclerosis and Related Disorders, 56, [103251]. https://doi.org/10.1016/j.msard.2021.103251

@article{24eaf5df364b4c04b728d3e9d39b0a9d,

title = "Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis",

abstract = "Background: The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy. Objective: To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS). Method: IgG Abs against SARS-CoV-2 spike receptor–binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60). Results: 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine. Conclusion: Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.",

keywords = "Anti-cd20, Clinical trials, Covid-19, Ocrelizumab, Sars-cov-2, Vaccination",

author = "Frederik Novak and Nilsson, {Anna Christine} and Christian Nielsen and Holm, {Dorte K.} and Kamilla {\O}stergaard and Anna Bystrup and Byg, {Keld Erik} and Johansen, {Isik S.} and Kristen Mittl and William Rowles and Kira Mcpolin and Collin Spencer and Sharon Sagan and Chloe Gerungan and Wilson, {Michael R.} and Zamvil, {Scott S.} and Riley Bove and Sabatino, {Joseph J.} and Tobias Sejbaek",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = nov,

doi = "10.1016/j.msard.2021.103251",

language = "English",

volume = "56",

journal = "Multiple Sclerosis and Related Disorders",

issn = "2211-0348",

publisher = "Elsevier",

}

Novak, F , Nilsson, AC, Nielsen, C, Holm, DK, Østergaard, K, Bystrup, A, Byg, KE , Johansen, IS, Mittl, K, Rowles, W, Mcpolin, K, Spencer, C, Sagan, S, Gerungan, C, Wilson, MR, Zamvil, SS, Bove, R, Sabatino, JJ & Sejbaek, T 2021, 'Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis', Multiple Sclerosis and Related Disorders, bind 56, 103251. https://doi.org/10.1016/j.msard.2021.103251

TY - JOUR

T1 - Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis

AU - Novak, Frederik

AU - Nilsson, Anna Christine

AU - Nielsen, Christian

AU - Holm, Dorte K.

AU - Østergaard, Kamilla

AU - Bystrup, Anna

AU - Byg, Keld Erik

AU - Johansen, Isik S.

AU - Mittl, Kristen

AU - Rowles, William

AU - Mcpolin, Kira

AU - Spencer, Collin

AU - Sagan, Sharon

AU - Gerungan, Chloe

AU - Wilson, Michael R.

AU - Zamvil, Scott S.

AU - Bove, Riley

AU - Sabatino, Joseph J.

AU - Sejbaek, Tobias

PY - 2021/11

Y1 - 2021/11

N2 - Background: The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy. Objective: To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS). Method: IgG Abs against SARS-CoV-2 spike receptor–binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60). Results: 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine. Conclusion: Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.

AB - Background: The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy. Objective: To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS). Method: IgG Abs against SARS-CoV-2 spike receptor–binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60). Results: 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine. Conclusion: Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.

KW - Anti-cd20

KW - Clinical trials

KW - Covid-19

KW - Ocrelizumab

KW - Sars-cov-2

KW - Vaccination

U2 - 10.1016/j.msard.2021.103251

DO - 10.1016/j.msard.2021.103251

M3 - Journal article

C2 - 34571415

AN - SCOPUS:85115661953

SN - 2211-0348

VL - 56

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

M1 - 103251

ER -

Humoral immune response following SARS-CoV-2 mRNA vaccination concomitant to anti-CD20 therapy in multiple sclerosis

Abstrakt

Bibliografisk note

Dokumenter og links

Fingeraftryk

Citationsformater