Abstract
Background: The immunogenicity of COVID-19 vaccine among patients receiving anti-CD20 monoclonal antibody (Ab) treatment has not been fully investigated. Detectable levels of SARS-CoV-2 immunoglobulin G (IgG) are believed to have a predictive value for immune protection against COVID-19 and is currently a surrogate indicator for vaccine efficacy.
Objective: To determine IgG Abs in anti-CD20 treated patients with multiple sclerosis (MS).
Method: IgG Abs against SARS-CoV-2 spike receptor-binding domain were measured with the SARS-CoV-2 IgG II Quant assay (Abbott Laboratories) before and after vaccination (n = 60).
Results: 36.7% of patients mounted a positive SARS-CoV-2 spike Ab response after the second dose of vaccine. Five patients (8.3%) developed Abs >264 BAU/mL, another 12 patients (20%) developed intermediate Abs between 54 BAU/mL and 264 BAU/mL and five patients (8.3%) had low levels <54 BAU/mL. Of all seropositive patients, 63.6% converted from seronegative to seropositive after the 2nd vaccine.
Conclusion: Our study demonstrates decreased humoral response after BNT162b2 mRNA SARS-CoV-2 vaccine in MS patients receiving B-cell depleting therapy. Clinicians should advise patients treated with anti-CD20 to avoid exposure to SARS-CoV-2. Future studies should investigate the implications of a third booster vaccine in patients with low or absent Abs after vaccination.
Keywords: Anti-cd20; Clinical trials; Covid-19; Ocrelizumab; Sars-cov-2; Vaccination.
【저자키워드】 COVID-19, SARS-CoV-2, vaccination, clinical trials, anti-CD20, Ocrelizumab, 【초록키워드】 Treatment, IgG, Efficacy, Vaccine, COVID-19 vaccine, vaccination, immunogenicity, therapy, multiple sclerosis, monoclonal antibody, vaccine efficacy, clinical trials, SARS-CoV-2 vaccine, Predictive value, BNT162b2, Immunoglobulin G, Immunoglobulin, clinical, Patient, patients, seropositive, seronegative, BNT162b2 mRNA, anti-CD20, Ocrelizumab, immune protection, SARS-CoV-2 spike, B-cell, CD20, Booster vaccine, humoral, Abbott, exposure to, Predictive, second dose, second dose of vaccine, domain, Abbott Laboratories, binding domain, positive, SARS-CoV-2 spike receptor-binding domain, SARS-CoV-2 IgG II Quant assay, Future, implication, FIVE, investigated, receiving, determine, depleting, were measured, mounted, patients treated, the SARS-CoV-2, treated patient, 【제목키워드】 mRNA vaccination, immune response, anti-CD20 therapy,