Reduced COVID antibody response in some MS patients

The antibody response after SARS-CoV-2 infection was reduced in patients with multiple sclerosis (MS) with ocrelizumab (Ocrevus) compared to other MS patients, but the T cell response was not reduced, according to a New York study. Preliminary data from.

Antibody detection varied, but T cell levels were similar in patients with COVID-19 and MS, regardless of the disease-modifying treatment used, said Dr. Ilya Kister of NYU Langone Health, New York City. Emerging science Session American Academy of Neurology Virtual conference.

“The top-line results of our study show that MS patients taking the B-cell depletion therapy ocrelizumab weaken their antibody response to the SARS-CoV-2 virus and SARS more than MS patients not taking ocrelizumab. It is much less likely to produce a neutralizing antibody against the virus. -CoV-2, “said Kister.

“On the other hand, SARS CoV-2 specific T cell responses were similar in patients treated with ocrelizumab and those treated with non-crelizumab, and clinically, the COVIDs in these two groups were of similar severity,” he said. It was. Today’s MedPage. “These findings suggest that patients treated with ocrelizumab can fight COVID-19 infection despite reduced antibody response. Perhaps with T cells, the other arm of the immune system. Because innate immunity provides adequate protection in most cases.

“It’s encouraging to see the T cell response to SARS-CoV-2 in patients undergoing B cell depletion monoclonal antibody therapy,” said Barry Singer, MD, MD, Missouri Baptist Medical Center, St. Louis. research.

“The study design provides a template for studying the COVID-19 vaccination response of patients with multiple sclerosis by assessing anti-spiking antibodies and T cell responses. Suffering from multiple sclerosis with disease-modifying therapy. The ultimate unanswered question for many people is that COVID-19 vaccination was prophylactic, “said Singer. Today’s MedPage.

Kister et al. Evaluated New York University MS patients infected with SARS-CoV-2 during the first wave of the COVID-19 pandemic in early 2020. Participants were evaluated for antibodies and T cells from January to March 2021. .. MS patients who have been vaccinated with COVID-19, who have been using anti-CD20 drugs other than ocrelizumab, have received high doses of steroids, intravenous immunoglobulin (IVIG), plasma, or antibody treatment in the last 3 months, or Comorbidities that may suppress the major immune system have been ruled out.

About one-third (36%) of patients were treated with ocrelizumab and 16% were untreated. The average age of participants was 41, with 70% being female. They had MS for an average of 11.5 years, and 86% had recurrent MS. Most were completely walkable.

A total of 59 patients in the group had laboratory-confirmed SARS-CoV-2. Evaluation of these patients included three antibody tests: Elecsys anti-SARS-CoV-2 (Roche Diagnostics) and NYU multiplex bead-based antibody response to SARS-CoV-2 nucleocapsid and peplomer. Immunoassay, and live virus immunofluorescence-based microneutralization assay. Some patients also underwent T cell response studies such as enzyme immunoassay (ELISpot) cytokine assay and SARS-CoV-2 TruCulture.

The NYU multiplex assay detected antibodies to SARS-CoV-2 in most MS patients regardless of treatment, but patients treated with occlillizumab were treated with other disease-modifying treatments or MS treatment. The levels of IgG anti-spiking antibody were significantly lower compared to patients who did not do it at all. .. The median maximum inhibitory concentration of neutralizing antibody (IC50) was lower in the ocrelizumab-treated group than in the other groups. T cell responses with ELISpot and TruCulture were similar in both patients treated with ocrelizumab and those not treated with ocrelizumab.

“One problem is the lack of easy access to T cell response tests,” said John Coboy, MD, MD, of the University of Colorado School of Medicine, who was not involved in the study. “But it’s encouraging to have a reaction, even though the antibody is lower.”

University of Colorado and NYU Langone Health Begins COVID-19 vaccine response study in MS Immediately the patient, Coboy added. “We plan to work with the Corona Group to conduct a longitudinal study of how patients treated with ocrelizumab generate an immune response of T cells and antibodies to the COVID-19 vaccine,” Kister said. Stated. “This study enrolls 60 patients and follows them for one year.”