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[多发性硬化症患者的新型冠状病毒2型疫苗接种]

[Vaccination against SARS-CoV-2 in patients with multiple sclerosis].

作者信息

Costa Frossard-França L, García-Domínguez J M, Moreno-Torres I, Fortún J, Villar L M, Meca-Lallana V

机构信息

Hospital Universitario Ramón y Cajal, Madrid, España.

Hospital Universitario Gregorio Marañón, Madrid, España.

出版信息

Rev Neurol. 2021 Apr 1;72(7):250-260. doi: 10.33588/rn.7207.2021097.

Abstract

INTRODUCTION

The recent availability of SARS-CoV-2 vaccines has raised concerns in certain patient groups, such as those with multiple sclerosis. However, there are currently few publications that provide information on this issue. We pooled the information available on the safety and efficacy of vaccination against SARS-CoV-2 in patients with multiple sclerosis, with and without disease-modifying therapy.

DEVELOPMENT

The study consisted in a literature search focused on the types of SARS-CoV-2 vaccines, the current status of their approval, and the data available on the safety and efficacy of vaccines in patients with multiple sclerosis, including the new COVID-19 vaccines. Based on this search, the document has been designed taking into account current evidence and expert recommendations. There are no data on the safety and efficacy of SARS-CoV-2 vaccines in patients with multiple sclerosis. However, evidence does exist to suggest that messenger RNA (mRNA) vaccines against SARS-CoV-2 are as safe in these patients as in other individuals. Some therapies with immunosuppressants might reduce the effectiveness of these vaccines and require the scheduling of their administration, preferably before the start of treatment if possible.

CONCLUSION

The data available make it possible to recommend mRNA vaccines against SARS-CoV-2 in patients with multiple sclerosis. In patients on fingolimod, cladribine, alemtuzumab, ocrelizumab and rituximab, vaccination prior to the initiation of medication administration would be recommendable whenever possible.

摘要

引言

近期可获得的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫苗引发了某些患者群体的担忧,例如多发性硬化症患者。然而,目前很少有出版物提供关于这个问题的信息。我们汇总了有关接受或未接受疾病修饰治疗的多发性硬化症患者接种SARS-CoV-2疫苗的安全性和有效性的现有信息。

进展

该研究包括文献检索,重点关注SARS-CoV-2疫苗的类型、其获批现状以及疫苗在多发性硬化症患者(包括新型冠状病毒病(COVID-19)疫苗)中的安全性和有效性数据。基于此次检索,该文件在考虑当前证据和专家建议的基础上进行了设计。目前尚无关于SARS-CoV-2疫苗在多发性硬化症患者中的安全性和有效性数据。然而,有证据表明,针对SARS-CoV-2的信使核糖核酸(mRNA)疫苗在这些患者中与在其他个体中一样安全。一些免疫抑制剂治疗可能会降低这些疫苗的有效性,需要安排其接种时间,如有可能,最好在治疗开始前进行。

结论

现有数据使得能够推荐在多发性硬化症患者中接种针对SARS-CoV-2的mRNA疫苗。对于使用芬戈莫德、克拉屈滨、阿仑单抗、奥瑞珠单抗和利妥昔单抗的患者,只要有可能,建议在开始用药前进行疫苗接种。

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COVID-19 Vaccination Reactogenicity in Persons With Multiple Sclerosis.COVID-19 疫苗在多发性硬化症患者中的反应原性。
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