Humoral COVID-19 vaccine response in patients with NMOSD/MOGAD during anti-IL-6 receptor therapy compared to other immunotherapies. (May 2023)

• Record Type: Journal Article
• Authors: Schwake, Carolin; Pakeerathan, Thivya; Kleiter, Ingo; Ringelstein, Marius; Aktas, Orhan; Korporal-Kuhnke, Mirjam; Wildemann, Brigitte; Jarius, Sven; Bayas, Antonios; Pul, Refik; Ceylan, Ulas; Faissner, Simon; Hellwig, Kerstin; Ayroza Galvao Ribeiro Gomes, Ana Beatriz; Lipps, Patrick; Pröbstel, Anne-Katrin; Kümpfel, Tania; Oswald, Eva; Then Bergh, Florian; Gödel, Clemens; Hümmert, Martin W; Trebst, Corinna; Gold, Ralf; Ayzenberg, Ilya
• Is Part Of: Multiple sclerosis. Volume 29:Number 6(2023)
• Page Start: 757
• Page End: 761
• Publication Date: 2023-05
• Subjects: Vaccination -- vaccine response -- COVID-19 -- SARS-CoV-2 -- MOGAD -- tocilizumab -- satralizumab; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/13524585221151124
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Data on the humoral vaccine response in patients on anti-interleukin-6 (IL-6) receptor therapy remain scarce. Objective: The main objective of our study was to investigate the humoral response after vaccination against SARS-CoV-2 in neuromyelitis optica spectrum disorder (NMOSD)/myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) patients treated with anti-IL-6 receptor therapy. Secondarily, we analyzed relapse activity timely associated with vaccination. Methods: In this retrospective cross-sectional multicenter study, we included 15 healthy controls and 48 adult NMOSD/MOGAD patients without previous COVID-19 infection. SARS-CoV-2 spike protein antibody titers during anti-IL-6 receptor therapy were compared to anti-CD20 antibody therapy, oral immunosuppressants, and to nonimmunosuppressed individuals. Results: We observed 100% seroconversion in the anti-IL-6 receptor treatment group. Titers of SARS-CoV-2 spike protein antibodies were lower compared to healthy controls (720 vs 2500 binding antibody units (BAU)/mL, p = 0.004), but higher than in the anti-CD20 (720 vs 0.4 BAU/mL, p < 0.001) and comparable to the oral immunosuppressant group (720 vs 795 BAU/mL, p = 1.0). We found no association between mRNA-based vaccines and relapse activity in patients with or without immunotherapy. Conclusions: Despite being lower than in healthy controls, the humoral vaccine response during anti-IL-6 receptor therapy was evident in all patients and substantially stronger compared to anti-CD20 treatment. No relevant disease activity occurred after mRNA vaccination against SARS-CoV-2.