tetano
Editor, Senior Moderator
Eur J Neurol
. 2024 Apr 19:e16300.
doi: 10.1111/ene.16300. Online ahead of print. Clinical effectiveness of coronavirus disease 2019 vaccination in patients with multiple sclerosis stratified by disease-modifying treatment
Marijke De Troyer[SUP] 1 2 [/SUP], Ann Van Remoortel[SUP] 3 [/SUP], Jeroen Van Schependom[SUP] 4 5 6 [/SUP], Laetitia Della Faille[SUP] 3 [/SUP], Marie B D'hooghe[SUP] 1 3 4 5 [/SUP], Gertjan Peeters[SUP] 1 7 [/SUP], Guy Nagels[SUP] 1 4 5 8 [/SUP], Miguel D'haeseleer[SUP] 1 3 4 5 [/SUP]
Affiliations
Background and purpose: Coronavirus disease 2019 (COVID-19) vaccination has been associated with a dampened humoral and/or cellular immune response in patients with multiple sclerosis (MS) who were concurrently on disease-modifying treatment (DMT) with B-cell depleting agents or sphingosine-1-phosphate receptor modulators (S1PRMs). Our main goal was to investigate the impact of these DMT classes on the clinical effectiveness of COVID-19 vaccination.
Methods: Since March 2020, demographics and clinical data of patients with MS who developed COVID-19 have been collected at the Belgian National MS Centre in Melsbroek. Patients were considered to be 'protected by vaccination' if they were (i) fully vaccinated and (ii) tested positive for COVID-19 in the period ranging from 14 days to 6 months after the last administered vaccine.
Results: On 19 December 2022, 418 COVID-19 cases were retrospectively identified in 389 individual patients. Hospitalization and mortality rates resulting from the infection were 10.8% and 2.4%, respectively. Being 'unprotected by vaccination' was significantly associated with a worse COVID-19 outcome (i.e., hospitalization and/or death) in the total cohort (N = 418, odds ratio [OR] 3.96), in patients on ongoing DMT other than anti-CD20 agents or S1PRMs (N = 123, OR 31.75) and in patients without DMT (N = 182, OR 5.60), but not in those receiving anti-CD20 agents (N = 91, OR 0.39); the S1PRMs subgroup was considered too small (22 infections) for any meaningful analysis.
Conclusions: Coronavirus disease 2019 vaccination protects against severe infection in patients with MS but it was not possible to confirm this effect in those on DMT with B-cell depleting agents.
Keywords: COVID‐19; disease‐modifying treatment; multiple sclerosis; vaccination.
. 2024 Apr 19:e16300.
doi: 10.1111/ene.16300. Online ahead of print. Clinical effectiveness of coronavirus disease 2019 vaccination in patients with multiple sclerosis stratified by disease-modifying treatment
Marijke De Troyer[SUP] 1 2 [/SUP], Ann Van Remoortel[SUP] 3 [/SUP], Jeroen Van Schependom[SUP] 4 5 6 [/SUP], Laetitia Della Faille[SUP] 3 [/SUP], Marie B D'hooghe[SUP] 1 3 4 5 [/SUP], Gertjan Peeters[SUP] 1 7 [/SUP], Guy Nagels[SUP] 1 4 5 8 [/SUP], Miguel D'haeseleer[SUP] 1 3 4 5 [/SUP]
Affiliations
- PMID: 38641878
- DOI: 10.1111/ene.16300
Background and purpose: Coronavirus disease 2019 (COVID-19) vaccination has been associated with a dampened humoral and/or cellular immune response in patients with multiple sclerosis (MS) who were concurrently on disease-modifying treatment (DMT) with B-cell depleting agents or sphingosine-1-phosphate receptor modulators (S1PRMs). Our main goal was to investigate the impact of these DMT classes on the clinical effectiveness of COVID-19 vaccination.
Methods: Since March 2020, demographics and clinical data of patients with MS who developed COVID-19 have been collected at the Belgian National MS Centre in Melsbroek. Patients were considered to be 'protected by vaccination' if they were (i) fully vaccinated and (ii) tested positive for COVID-19 in the period ranging from 14 days to 6 months after the last administered vaccine.
Results: On 19 December 2022, 418 COVID-19 cases were retrospectively identified in 389 individual patients. Hospitalization and mortality rates resulting from the infection were 10.8% and 2.4%, respectively. Being 'unprotected by vaccination' was significantly associated with a worse COVID-19 outcome (i.e., hospitalization and/or death) in the total cohort (N = 418, odds ratio [OR] 3.96), in patients on ongoing DMT other than anti-CD20 agents or S1PRMs (N = 123, OR 31.75) and in patients without DMT (N = 182, OR 5.60), but not in those receiving anti-CD20 agents (N = 91, OR 0.39); the S1PRMs subgroup was considered too small (22 infections) for any meaningful analysis.
Conclusions: Coronavirus disease 2019 vaccination protects against severe infection in patients with MS but it was not possible to confirm this effect in those on DMT with B-cell depleting agents.
Keywords: COVID‐19; disease‐modifying treatment; multiple sclerosis; vaccination.