Neurological

B-cell depletion affects SARS-CoV-2 antibody production in patients with MS

B-cell depletion in patients with multiple sclerosis (MS) can affect the production of antibodies against coronavirus 2 (SARS-CoV-2) with severe acute respiratory syndrome.

This study included 546 patients with MS (mean age 46.9 years) who had visited the MS Center Amsterdam in Amsterdam, the Netherlands, in the past 2 years. The study’s investigators drew blood samples to measure SARS-CoV-2 antibodies.

About a week later, participants completed digital questionnaires to provide data on patient characteristics, current illness-related complaints, and COVID-19 symptoms. Study investigators obtained other MS-specific data from participants’ medical records.

Continue reading

Approximately 11.7% (n = 64) of the patients had detectable SARS-CoV-2 antibodies in their blood. A total of 35 patients developed COVID-19, which was determined by polymerase chain reaction (PCR) tests. Up to 11% (n = 4 patients) of those who tested positive by PCR tested negative for SARS-CoV-2 antibodies.

No COVID-19 symptoms were reported in 9 patients who tested positive for SARS-CoV-2 antibodies. Loss of taste / smell was the most commonly reported symptom in 47% of patients who tested positive. Only 2.9% of the patients without SARS-CoV-2 antibodies reported a loss of taste or smell. No deaths were recorded in the MS cohort of patients who developed COVID-19.

The majority of patients (74.2%) received treatment with disease-modifying drugs. In patients treated with these therapies, the investigators observed less frequent SARS-CoV-2 antibodies in patients using injectable drugs (interferon β and glatiramer acetate) than in patients using other treatments (4% versus 13, 1%; P = .04).

Patients treated with ocrelizumab had a lower median SARS-CoV-2 antibody response than patients treated with other therapies (0.2 nOD versus 2.5 nOD; P <0.001). In addition, patients taking ocrelizumab were considered B-cell depleted for a median of 2.5 (0-41) days prior to measurement of the antibody response. At this point, none of the patients showed signs of hypogammaglobulinaemia.

One possible limitation of this study was the small percentage of patients who tested positive for SARS-CoV-2.

Despite this limitation, the study’s researchers concluded that their results imply that “B-cell depletion may affect SARS-CoV-2 antibody production in patients with MS” and that these results have “important humoral consequences Immunity after COVID-19 infection and possibly vaccination. “

Disclosure: Several authors of the study have stated that they are part of the pharmaceutical industry. For a full list of the authors’ information, see the original reference.

reference

van Kempen ZLE, Strijbis EMM, Al MMCT et al. SARS-CoV-2 Antibodies in Adult Multiple Sclerosis Patients in the Amsterdam MS Cohort. JAMA Neurol. Published online April 30, 2021. doi: 10.1001 / jamaneurol.2021.1364

Related Articles