TY - JOUR T1 - Anti-CD20 therapies decrease humoral immune response to SARS-CoV-2 in patients with multiple sclerosis or neuromyelitis optica spectrum disorders JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 24 LP - 31 DO - 10.1136/jnnp-2021-326904 VL - 93 IS - 1 AU - Céline Louapre AU - Michella Ibrahim AU - Elisabeth Maillart AU - Basma Abdi AU - Caroline Papeix AU - Bruno Stankoff AU - Anne-Laure Dubessy AU - Caroline Bensa-Koscher AU - Alain Créange AU - Zina Chamekh AU - Catherine Lubetzki AU - Anne-Geneviève Marcelin AU - Jean-Christophe Corvol AU - Valérie Pourcher A2 - , Y1 - 2022/01/01 UR - http://jnnp.bmj.com/content/93/1/24.abstract N2 - Background SARS-CoV-2 seroconversion rate after COVID-19 may be influenced by disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMO-SD).Objective To investigate the seroprevalence and the quantity of SARS-CoV-2 antibodies in a cohort of patients with MS or NMO-SD.Methods Blood samples were collected in patients diagnosed with COVID-19 between 19 February 2020 and 26 February 2021. SARS-CoV-2 antibody positivity rates and Ig levels (anti-S IgG titre, anti-S IgA index, anti-N IgG index) were compared between DMTs groups. Multivariate logistic and linear regression models were used to estimate the influence of DMTs and other confounding variables on SARS-CoV-2 serological outcomes.Results 119 patients (115 MS, 4 NMO, mean age: 43.0 years) were analysed. Overall, seroconversion rate was 80.6% within 5.0 (SD 3.4) months after infection. 20/21 (95.2%) patients without DMT and 66/77 (85.7%) patients on DMTs other than anti-CD20 had at least one SARS-CoV-2 Ig positivity, while this rate decreased to only 10/21 (47.6%) for patients on anti-CD20 (p<0.001). Being on anti-CD20 was associated with a decreased odd of positive serology (OR, 0.07 (95% CI 0.01 to 0.69), p=0.02) independently from time to COVID-19, total IgG level, age, sex and COVID-19 severity. Time between last anti-CD20 infusion and COVID-19 was longer (mean (SD), 3.7 (2.0) months) in seropositive patients compared with seronegative patients (mean (SD), 1.9 (1.5) months, p=0.04).Conclusions SARS-CoV-2 antibody response was decreased in patients with MS or NMO-SD treated with anti-CD20 therapies. Monitoring long-term risk of reinfection and specific vaccination strategies in this population may be warranted.Trial registration number NCT04568707.Data may be obtained from a third party and are not publicly available. Deidentified participant data may be obtained during 15 years from our institution Assistance Publique des Hôpitaux de Paris and are not publicly available. ER -