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Forschungsdatenbank PMU-SQQUID

Long-term immunological consequences of anti-CD20 therapies on humoral responses to COVID-19 vaccines in multiple sclerosis: an observational study.
Moser, T; OSullivan, C; Otto, F; Hitzl, W; Pilz, G; Schwenker, K; Mrazek, C; Haschke-Becher, E; Trinka, E; Wipfler, P; Harrer, A;
Ther Adv Neurol Disord. 2022; 15: 17562864221092092
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Harrer Andrea
Haschke-Becher Elisabeth
Hitzl Wolfgang
Moser Tobias
Mrazek Cornelia
Otto Ferdinand
Pilz Georg
Schwenker Kerstin
Trinka Eugen
Wipfler Peter

Abstract

Background
Anti-CD20 therapies induce pronounced B-cell depletion and blunt humoral responses to vaccines. Recovery kinetics of anti-CD20 therapy-mediated cellular and humoral effects in people with multiple sclerosis (pwMS) are poorly defined.
To investigate the duration of the anti-CD20 treatment-induced effects on humoral responses to COVID-19 vaccines.
This retrospective observational study included pwMS who had discontinued anti-CD20 therapy for ⩾12 months and remained without immunomodulation. We retrieved demographics and laboratory parameters including B-cell counts and immunoglobulin (IgG, IgM, IgA) levels prior to anti-CD20 commencement (baseline) and longitudinally after anti-CD20 treatment discontinuation from electronic medical records. Humoral responses to SARS-CoV-2 vaccines were compared with a population of 11 pwMS with ongoing anti-CD20 medication (control cohort).
A total of 24 pwMS had discontinued anti-CD20 therapy for a median of 34 months (range: 16-38 months). Antibody responses to COVID-19 vaccines were available in 17 (71%). Most individuals (n = 15, 88%) elicited a measurable antibody response [mean: 774 BAU/ml (±SD 1283 BAU/ml)] to SARS-CoV-2 immunization on average 22 months (range: 10-30 months) from the last anti-CD20 infusion, which was higher compared with the population with ongoing anti-CD20 therapy (n = 11, mean: 12.36 ± SD 11.94 BAU/ml; p < 0.00001). Significantly increased antibody levels compared with the control cohort were found among pwMS who were vaccinated >18 months after treatment discontinuation (19-24 months: n = 2, p = 0.013; 25-36 months: n = 9; p < 0.001). The interindividual kinetics for B-cell reconstitution were heterogeneous and mean B-cell counts approached normal ranges 18 months after treatment discontinuation. There was no correlation of B-cell repopulation and vaccine responses. Mean total IgG, IgM, and IgA levels remained within the reference range.
Anti-CD20-induced inhibition of humoral responses to COVID-19 vaccines is transient and antibody production was more pronounced >18 months after anti-CD20 treatment discontinuation. The immunological effect on B-cell counts appears to wane by the same time.


Find related publications in this database (Keywords)

antibody titers
B-cell depletion
B-cell therapy
immune reconstitution
immunoglobulins
long-term effects
SARS-CoV-2