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Abstract
Background Although vaccination against SARS-CoV-2 is recommended prior to introducing anti-CD20 therapies, limited data are available regarding the evolution of post-vaccinal immunity.
Methods This retrospective study compared anti-Spike antibody titres at 6 and 12 months from SARS-CoV-2 vaccination between patients vaccinated before switching to anti-CD20 (‘Switch’) and two control groups: (1) patients vaccinated under disease-modifying therapies (DMTs) other than fingolimod and anti-CD20 (‘Other DMTs’); (2) patients vaccinated on anti-CD20 (‘Anti-CD20’). Anti-Spike-specific T-cell responses were compared between ‘Switch’ and ‘Anti-CD20’ groups.
Results Fifty-three patients were included in the ‘Switch’ group, 54 in the ‘Other DMTs’ group and 141 in the ‘Anti-CD20’ group. At 6 months, in the subset of patients who received a booster dose, the ‘Switch’ group had lower anti-Spike titres compared with the ‘Other DMTs’ group (median 241.0 IQR (88.0; 504.0) BAU/mL vs 2034 (1155; 4634) BAU/mL, p<0.001), and less patients in the ‘Switch’ group reached the protective threshold of 264 BAU/mL. The ‘Switch’ group had higher anti-Spike titres than the ‘Anti-CD20’ group (7.5 (0.0; 62.1) BAU/mL, p=0.001). Anti-Spike titres were not different between the ‘Switch’ and ‘Other DMTs’ groups before booster administration. These results were similar at 12 months. Spike-specific T-cell positivity was similar between the ‘Switch’ and ‘Anti-CD20’ groups at 6 and 12 months (60.4% vs 61.0%, p=0.53, and 79.4% vs 87.5%, p=0.31, respectively).
Conclusions Despite a primary vaccination performed before the first anti-CD20 cycle, our results suggest weaker immune responses at 6 and 12 months and decreased booster efficacy after introducing anti-CD20. Patients vaccinated prior to anti-CD20 introduction might falsely be considered as fully protected by vaccination.
- MULTIPLE SCLEROSIS
- COVID-19
- IMMUNOLOGY
Data availability statement
Data are available upon reasonable request. The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
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Data availability statement
Data are available upon reasonable request. The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
Footnotes
Twitter @clouapre
Contributors CL accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.
LJ participated in the study conception, collected and interpreted the data, performed statistical analysis, designed the figures and wrote the first draft of the manuscript. BA, CS and A-GM provided serology data and analyses and participated in data interpretation. DS provided specific T-cell data and analyses and participated in data interpretation. EM, YB and AH participated in major revisions of the manuscript. LB contributed to data interpretation and major revisions of the manuscript. VM participated in data interpretation and major revisions of the manuscript. CL supervised the study, participated in the study conception, data collection and interpretation. All authors contributed to critical revision of the manuscript and have read and approved its final version. CL accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.
Funding Part of the data used in one of the control groups of this study was extracted from the COVIVAC-ID study that was supported by Roche and by a grant from Assistance Publique – Hôpitaux de Paris. The biological Cohort COVID-19 Neurosciences (BioCoCo Neurosciences), was funded by the generous support of the Fédération Internationale de l'Automobile (FIA) Foundation, the Fondation de France Grant No 00113315, and donors of Paris Brain Institute – ICM.
Competing interests CL has received consulting or travel fees from Biogen, Novartis, Roche, Sanofi, Teva and Merck Serono, and research grant from Biogen, none related to the present work. EM has received consulting or travel fees from Alexion, Biogen, Horizon, Janssen, Merck, Novartis, Sanofi and Teva, and research grant from Biogen, none related to the present work. VP has received consulting or travel fees from Gilead, ViiV, MSD, Biogen, Novartis, Roche and Merck Serono, none related to the present work. LJ, BA, CS, DS, YB, AH, LB and A-GM have no competing interest to declare.
Provenance and peer review Not commissioned; externally peer reviewed.
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