Factors (ref) | Post-vac outcomes | |||||||
B-cell response | T-cell response | |||||||
Seroconversion | IFN-g release | CD4 +AIM+ | CD8 +AIM+ | |||||
OR (95% CI) | P value (certainty*) | OR (95% CI) | P value (certainty*) | OR (95% CI) | P value (certainty*) | OR (95% CI) | P value (certainty*) | |
DMT (UX) | ||||||||
-IFN | 0.84 (0.38 to 1.83) | 0.66 Moderate1,2 | 0.02 (0.00 to 0.14) | <0.01 very low2,4,5 | Ni | Ni | ||
-GA | 0.87 (0.31 to 2.42) | 0.79 Moderate1,2 | Ni | NE | 0.62 (0.04 to 9.00) | 0.72 very low1,2,4,5 | ||
-DMF | 1.98 (0.96 to 4.09) | 0.07 Moderate1,2 | Ni | NE | 3.78 (0.18 to 78.38) | 0.39 very low1,2,4,5 | ||
-TERI | 0.38 (0.16 to 0.90) | 0.03 very low2,3 | Ni | Ni | Ni | |||
-S1PRM | 0.04 (0.03 to 0.06) | <0.00001 High1 | 0.04 (0.02 to 0.07) | <0.00001 Low1,2,3 | 0.01 (0.00 to 0.18) | 0.001 very low2,4,5 | 0.95 (0.08 to 10.71) | 0.97 very low1,2,4,5 |
-NTZ | 0.53 (0.24 to 1.18) | 0.12 Low1,2,4 | 1.00 (0.20 to 5.12) | 1.00 very low1,2,4,5 | NE | 3.95 (0.23 to 69.44) | 0.35 very low1,2,4,5 | |
-CLAD | 0.41 (0.15 to 1.11) | 0.08 Low1,2,5 | 0.01 (0.00 to 0.04) | <0.00001 Low1,2,5 | Ni | Ni | ||
-ALEM | 0.32 (0.10 to 0.96) | 0.04 Very Low2,3 | Ni | Ni | Ni | |||
-aCD20 | 0.05 (0.04 to 0.06) | <0.00001 High1 | 1.12 (0.62 to 2.05) | 0.70 Moderate1,3 | 1.13 (0.17 to 7.61) | 0.90 Moderate1,2 | 2.54 (0.89 to 7.27) | 0.08 Moderate1,5 |
aCD20 infusion-to-vac (per 10 weeks) | 1.94 (1.57 to 2.41) | <0.00001 High1 | Ni | Ni | Ni |
Results with p<0.05 are bolded.
*Based on GRADE approach (Baseline: moderate due to observational nature of studies; upgrade; downgrade): 1. Result in line with quantitative analyses in individual studies; 2. Low count of studies with measurable relative effect; 3. Inconsistency; 4. Risk of missing results and 5. Imprecision.
aCD20, anti-CD20 therapies; AIM, activation-induced marker; ALEM, alemtuzumab; CLAD, cladribine; DMF, dimethyl fumarate; DMT, disease-modifying therapy; GA, glatiramer acetate; GRADE, Grades of Recommendations, Assessment, Development and Evaluation; IFN, interferons; IFN-g, interferon-gamma; NE, not estimable; Ni, no information; NTZ, natalizumab; ref, reference; S1PRM, sphingosine-1-phosphate receptor modulators; TERI, teriflunomide; UX, unexposed; vac, vaccination.