RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP 24
OP 31
DO 10.1136/jnnp-2021-326904
VO 93
IS 1
A1 Louapre, Céline
A1 Ibrahim, Michella
A1 Maillart, Elisabeth
A1 Abdi, Basma
A1 Papeix, Caroline
A1 Stankoff, Bruno
A1 Dubessy, Anne-Laure
A1 Bensa-Koscher, Caroline
A1 Créange, Alain
A1 Chamekh, Zina
A1 Lubetzki, Catherine
A1 Marcelin, Anne-Geneviève
A1 Corvol, Jean-Christophe
A1 Pourcher, Valérie
A1 
YR 2022
UL http://jnnp.bmj.com/content/93/1/24.abstract
AB 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.