Anti-CD20 therapies decrease humoral immune response to SARS-CoV-2 in patients with multiple sclerosis or neuromyelitis optica spectrum disorders

被引：42

作者：

Louapre, Celine ^{[1
]}

Ibrahim, Michella ^{[1
]}

Maillart, Elisabeth ^{[1
]}

Abdi, Basma ^{[2
]}

Papeix, Caroline ^{[1
]}

Stankoff, Bruno ^{[3
]}

Dubessy, Anne-Laure ^{[3
]}

Bensa-Koscher, Caroline ^{[4
]}

Creange, Alain ^{[5
,6
]}

Chamekh, Zina ^{[7
]}

Lubetzki, Catherine ^{[1
]}

Marcelin, Anne-Genevieve ^{[2
]}

Corvol, Jean-Christophe ^{[1
]}

Pourcher, Valerie ^{[8
]}

机构：

[1] Sorbonne Univ, Hop Pitie Salpetriere, AP HP,INSERM, Dept Neurol,Paris Brain Inst ICM,CNRS,CIC Neurosc, Paris, France

[2] Sorbonne Univ, Hop Pitie Salpetriere, AP HP, INSERM,Inst Pierre Louis Epidemiol & Sante Publ, Paris, France

[3] Sorbonne Univ, St Antoine Hosp, AP HP, CNRS,INSERM,Paris Brain Inst ICM,Dept Neurol, Paris, France

[4] Fdn Adolphe Rothschild Hosp, Dept Neurol, Paris, Ile De France, France

[5] UPEC Univ, Grp Hosp Henri Mondor, Serv Neurol, Creteil, Ile De France, France

[6] AP HP, CRC SEP, Creteil, Ile De France, France

[7] Hop La Pitie Salpetriere, AP HP, Biochem Dept, Paris, Ile De France, France

[8] Sorbonne Univ, Hop Pitie Salpetriere, AP HP,Serv Malad Infect, INSERM,Inst Pierre Louis Epiderniol & Sante Publ, Paris, Ile De France, France

来源：

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY | 2022年 / 93卷 / 01期

关键词：

multiple sclerosis; COVID-19; RITUXIMAB;

D O I：

10.1136/jnnp-2021-326904

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background SARS-CoV-2 seroconversion rate after COVID-19 may be influenced by disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMO-SD). Objective To investigate the seroprevalence and the quantity of SARS-CoV-2 antibodies in a cohort of patients with MS or NMO-SD. Methods Blood samples were collected in patients diagnosed with COVID-19 between 19 February 2020 and 26 February 2021. SARS-CoV-2 antibody positivity rates and Ig levels (anti-S IgG titre, anti-S IgA index, anti-N IgG index) were compared between DMTs groups. Multivariate logistic and linear regression models were used to estimate the influence of DMTs and other confounding variables on SARS-CoV-2 serological outcomes. Results 119 patients (115 MS, 4 NMO, mean age: 43.0 years) were analysed. Overall, seroconversion rate was 80.6% within 5.0 (SD 3.4) months after infection. 20/21 (95.2%) patients without DMT and 66/77 (85.7%) patients on DMTs other than anti-CD20 had at least one SARS-CoV-2 Ig positivity, while this rate decreased to only 10/21 (47.6%) for patients on anti-CD20 (p<0.001). Being on anti-CD20 was associated with a decreased odd of positive serology (OR, 0.07 (95% CI 0.01 to 0.69), p=0.02) independently from time to COVID-19, total IgG level, age, sex and COVID-19 severity. Time between last anti-CD20 infusion and COVID-19 was longer (mean (SD), 3.7 (2.0) months) in seropositive patients compared with seronegative patients (mean (SD), 1.9 (1.5) months, p=0.04). Conclusions SARS-CoV-2 antibody response was decreased in patients with MS or NMO-SD treated with anti-CD20 therapies. Monitoring long-term risk of reinfection and specific vaccination strategies in this population may be warranted.

引用

页码：24 / 31

页数：8