COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections.
COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections.
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DOI：
10.3390/vaccines10050695
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发表时间：
2022-04-28
期刊：
影响因子：
7.8
通讯作者：
Weinstock-Guttman, Bianca
中科院分区：
文献类型：
--
作者：
Jakimovski, Dejan;Zakalik, Karen;Awan, Samreen;Kavak, Katelyn S.;Pennington, Penny;Hojnacki, David;Kolb, Channa;Lizarraga, Alexis A.;Eckert, Svetlana P.;Sarrosa, Rosila;Vineetha, Kamath;Edwards, Keith;Weinstock-Guttman, Bianca
背景资料：确定疾病修饰疗法（DMT）对多发性硬化症（PwMS）和其他神经炎症性疾病患者的体液疫苗后血清转换、长期体液应答和突破性COVID-19感染的影响。研究方法：在两个MS中心共招募了757名PwMS和其他神经炎性疾病患者，并接种了FDA批准的疫苗之一（BNT 162 b2，mRNA-1273，Ad26.COV2.S）。主要结果是不同DMT患者之间的体液疫苗后血清转换率和抗严重急性呼吸综合征冠状病毒2（抗SARS-CoV-2）免疫球蛋白G（IgG）差异。次要指标包括六个月后的突破性感染和体液反应。其他结果包括SARS-CoV-2疫苗之间疫苗反应的差异以及年龄和合并症对疫苗反应的影响。结果：465例（68.4%）PwMS和55例（74.3%）神经炎性疾病患者在接种后4-12周血清学阳性。基于接种时使用的DMT，观察到血清转换的显著差异（p < 0.001），在抗CD 20抗体（23.2%）和1-磷酸鞘氨醇调节剂（S1 P）（30.8%）治疗的患者中观察到的发生率最低。在血清阳性患者中，抗SARS IgG在6个月时从平均20.0显著降低至4.7（p = 0.004）。39名患者发生突破性感染，但只有2名血清阴性患者需要住院治疗。与Ad26.C0V2.S相比，mRNA疫苗导致显著更大的血清转化（p < 0.001）。年龄较大和心血管合并症的存在与较低的抗SARS IgG相关（分别为p = 0.021和p = 0.003）结论：抗SARS-CoV-2疫苗接种后，即使在加强剂量后，用抗CD 20和S1 P药物治疗的PwMS和神经炎性疾病的体液反应也较低。体液反应的减弱使接种疫苗的PwMS面临更大的COVID-19突破风险。
Background: To determine the effect of disease-modifying therapies (DMT) on humoral postvaccine seroconversion, long-term humoral response, and breakthrough COVID-19 infections in persons with multiple sclerosis (PwMS) and other neuroinflammatory disorders. Methods: A total of 757 PwMS and other neuroinflammatory disorders were recruited in two MS centers and vaccinated with one of the FDA-approved vaccines (BNT162b2, mRNA-1273, Ad26.COV2.S). The primary outcomes are the rate of humoral postvaccine seroconversion and anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) immunoglobulin G (IgG) differences between patients on different DMTs. Secondary measures include breakthrough infections and humoral response after six months. Other outcomes include differences in vaccine response between SARS-CoV-2 vaccines and the effects of age and comorbidities on the vaccine response. Results: A total of 465 (68.4%) PwMS and 55 (74.3%) patients with neuroinflammatory diseases were seropositive at 4–12 weeks after vaccination. A significant difference in seroconversion based on the DMT used at the time of vaccination (p < 0.001) was observed, with the lowest rates seen in patients treated with anti-CD20 antibodies (23.2%) and sphingosine-1-phosphate modulators (S1P) (30.8%). In seropositive patients, there was a significant decrease in anti-SARS IgG from mean 20.0 to 4.7 at six months (p = 0.004). Thirty-nine patients had breakthrough infection, but only two seronegative patients required hospitalization. mRNA vaccines resulted in significantly greater seroconversion compared to Ad26.COV2.S (p < 0.001). Older age and presence of cardiovascular comorbidities were associated with lower anti-SARS IgG (p = 0.021 and p = 0.003, respectively) Conclusions: PwMS and neuroinflammatory disorders treated with anti-CD20 and S1P medications have lower humoral response after anti-SARS-CoV-2 vaccination, even after booster dose. Waning of the humoral response puts vaccinated PwMS at a greater risk of COVID-19 breakthrough.
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影响因子：
11.1
作者：
Sormani MP;Inglese M;Schiavetti I;Carmisciano L;Laroni A;Lapucci C;Da Rin G;Serrati C;Gandoglia I;Tassinari T;Perego G;Brichetto G;Gazzola P;Mannironi A;Stromillo ML;Cordioli C;Landi D;Clerico M;Signoriello E;Frau J;Ferrò MT;Di Sapio A;Pasquali L;Ulivelli M;Marinelli F;Callari G;Iodice R;Liberatore G;Caleri F;Repice AM;Cordera S;Battaglia MA;Salvetti M;Franciotta D;Uccelli A;CovaXiMS study group on behalf of the Italian Covid-19 Alliance in MS
通讯作者：
CovaXiMS study group on behalf of the Italian Covid-19 Alliance in MS
影响因子：
4
作者：
Schiavetti I;Ponzano M;Signori A;Bovis F;Carmisciano L;Sormani MP
通讯作者：
Sormani MP
影响因子：
48
作者：
Thompson, Alan J.;Banwell, Brenda L.;Cohen, Jeffrey A.
通讯作者：
Cohen, Jeffrey A.
DOI：
10.1056/nejmoa2109072
发表时间：
2021-10-14
期刊：
The New England journal of medicine
影响因子：
--
作者：
Bergwerk M;Gonen T;Lustig Y;Amit S;Lipsitch M;Cohen C;Mandelboim M;Levin EG;Rubin C;Indenbaum V;Tal I;Zavitan M;Zuckerman N;Bar-Chaim A;Kreiss Y;Regev-Yochay G
通讯作者：
Regev-Yochay G
影响因子：
5.5
作者：
Shachor-Meyouhas Y;Hussein K;Szwarcwort-Cohen M;Weissman A;Mekel M;Dabaja-Younis H;Hyams G;Horowitz NA;Kaplan M;Halberthal M
通讯作者：
Halberthal M