Department of Neurology, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081 HV Amsterdam, the Netherland.
Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherland.
Mult Scler Relat Disord. 2022 Jan;57:103416. doi: 10.1016/j.msard.2021.103416. Epub 2021 Nov 23.
The objective of this study was to measure humoral responses after SARS-CoV-2 vaccination in MS patients treated with ocrelizumab (OCR) compared to MS patients without disease modifying therapies (DMTs) in relation to timing of vaccination and B-cell count.
OCR treated patients were divided into an early and a late group (cut-off time 12 weeks between infusion and first vaccination). Patients were vaccinated with mRNA-1273 (Moderna). B-cells were measured at baseline (time of first vaccination) and SARS-CoV-2 antibodies were measured at baseline, day 28, 42, 52 and 70.
87 patients were included (62 OCR patients, 29 patients without DMTs). At day 70, seroconversion occurred in 39.3% of OCR patients compared to 100% of MS patients without DMTs. In OCR patients, seroconversion varied between 26% (early group) to 50% (late group) and between 27% (low B-cells) to 56% (at least 1 detectable B-cell/µL).
Low B-cell counts prior to vaccination and shorter time between OCR infusion and vaccination may negatively influence humoral response but does not preclude seroconversion. We advise OCR treated patients to get their first vaccination as soon as possible. In case of an additional booster vaccination, timing of vaccination based on B-cell count and time after last infusion may be considered.
本研究旨在测量接受奥瑞珠单抗（OCR）治疗的 MS 患者与未接受疾病修正治疗（DMT）的 MS 患者在接种疫苗时间和 B 细胞计数方面，接种 SARS-CoV-2 疫苗后的体液反应。
将接受 OCR 治疗的患者分为早期和晚期组（输注和首次接种之间的截止时间为 12 周）。患者接种 mRNA-1273（Moderna）疫苗。在基线（首次接种时）测量 B 细胞，在基线、第 28、42、52 和 70 天测量 SARS-CoV-2 抗体。
共纳入 87 例患者（62 例 OCR 患者，29 例无 DMT）。在第 70 天，OCR 患者中有 39.3%发生血清转换，而无 DMT 的 MS 患者为 100%。在 OCR 患者中，血清转化率在 26%（早期组）至 50%（晚期组）之间变化，在 27%（低 B 细胞）至 56%（至少有 1 个可检测 B 细胞/µL）之间变化。
接种疫苗前 B 细胞计数低和 OCR 输注与接种疫苗之间的时间间隔较短可能会对体液反应产生负面影响，但不会排除血清转换。我们建议 OCR 治疗的患者尽快接种第一剂疫苗。如果需要额外的加强疫苗接种，可根据 B 细胞计数和上次输注后时间来考虑接种疫苗的时间。
