接受疾病修饰治疗的多发性硬化症患者的COVID-19疫苗接种
COVID-19 Vaccination in Patients With Multiple Sclerosis on Disease-Modifying Therapy.
作者信息
Wolf Andrew, Alvarez Enrique
机构信息
Department of Neurology, University of Colorado School of Medicine, Aurora.
出版信息
Neurol Clin Pract. 2021 Aug;11(4):358-361. doi: 10.1212/CPJ.0000000000001088.
Abstract
The COVID-19 pandemic has resulted in challenges for the practice of neurology. One major concern is how to best manage patients with multiple sclerosis (MS) who are on disease-modifying therapies (DMTs). DMTs frequently have immunosuppressive properties that both increase the risk for COVID-19 and potentially reduce the immunologic response to vaccination in a group already vulnerable to infection due to neurologic deficits. Here, we review early data on COVID-19 outcomes in patients with MS and discuss what is known about vaccine effectiveness in those on anti-CD20 and sphingosine-1-phosphate receptor agents, which are proposed to have attenuating effects based on their mechanisms of action. In addition, we provide recommendations to best use novel COVID-19 vaccines in this population and highlight what information may better inform vaccine strategies in the future.
摘要
新型冠状病毒肺炎（COVID-19）大流行给神经病学实践带来了挑战。一个主要问题是如何最好地管理正在接受疾病修正治疗（DMTs）的多发性硬化症（MS）患者。DMTs通常具有免疫抑制特性，这既增加了感染COVID-19的风险，又可能降低该组因神经功能缺损本就易受感染的人群对疫苗的免疫反应。在此，我们回顾了MS患者COVID-19转归的早期数据，并讨论了关于抗CD20和1-磷酸鞘氨醇受体药物使用者疫苗有效性的已知情况，这些药物因其作用机制被认为具有减弱作用。此外，我们提供了在该人群中最佳使用新型COVID-19疫苗的建议，并强调哪些信息可能为未来的疫苗策略提供更好的参考。
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