Abstract Details

Title Survey of Immune Response to SARS-CoV-2 mRNA Vaccines in Patients on anti-CD20 Therapy for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder.

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-002

Background To achieve adequate immunity against SARS-CoV-2, mRNA vaccines (BNT162b2 or mRNA-1273) stimulate B and T cells. Therefore, it is imperative to ensure MS/NMOSD patients on anti-CD20 therapy have enough B cells to produce antibodies at the time of vaccination.

Objective To determine the optimal time for SARS-CoV-2 mRNA vaccination, after infusion with anti-CD20 therapy, in patients with multiple sclerosis and neuromyelitis optica spectrum disorder (MS/NMOSD) as there are currently no guidelines.

Design/Methods This was a retrospective study at Rutgers New Jersey Medical School, Newark. We identified all MS/NMOSD patients on anti-CD20 therapy (Ocrelizumab or Rituximab) who received a SARS-CoV-2 mRNA vaccine. Some of these patients were not on the standard, biannual dosing schedule due to treatment guideline modifications made during the pandemic. Antibody response to the SARS-CoV-2 spike protein was checked at least 4 weeks after the second dose of the vaccine.

Results We analyzed 23 vaccinated MS/NMOSD patients on anti-CD20 therapy (87% on Ocrelizumab and 13% on Rituximab). Patients were divided into two groups: those who developed antibodies after vaccination (52%) and those who did not (48%). There was no significant difference between the two groups in age, gender, MS type, expanded disability status scale, type of anti-CD20 therapy, and brand of vaccine. However, there was statistical significance in the interval between infusion and vaccination between the groups (p-value – 0.03; 9.2±3.9 vs 6.2±3.1months). Additionally, none of these patients had a relapse.

Conclusions The mean interval between infusion and vaccination was 9.2 months in those that developed antibodies and 6.2 months in those that did not. Patients on anti-CD20 therapy may mount an immune response when vaccinated if the time between infusion and vaccination is extended beyond 6 months. The main limitation of this study was the variable timing in the collection of CD19 counts.

Authors/Disclosures
Toluwalase O. Tofade, MBBS (Medstar) PRESENTER	Dr. Tofade has nothing to disclose.
Pratibha Surathi, MD (Rutgers New Jersey Medical School)	Dr. Surathi has nothing to disclose.
Jorge L. Rodriguez Lee, MD (Yale School of Medicine)	Dr. Rodriguez Lee has nothing to disclose.
Machteld E. Hillen, MD, FAAN (Rutgers-NJMS)	The institution of Dr. Hillen has received research support from Genentech.