Prof G did a post cladribine 2, fingolimod 0 and there was one for ocrelizumab…this small study supports that result. Anti-CD20 clearly inhibits the antibody response towards the COVID-19 vaccine and and cladribine treated people responding well. All explained by Biology 101, I think. You give vaccine to people after the drug is long gone and what is there to response…responds. Treat whilst the drug is still present and depleting the B cells and you get a blunted B cell response.
Buttari F, Bruno A, Dolcetti E, Azzolini F, Bellantonio P, Centonze D, Fantozzi R. COVID-19 vaccines in multiple sclerosis treated with cladribine or ocrelizumab. Mult Scler Relat Disord. 2021 May 4;52:102983. doi: 10.1016/j.msard.2021.102983.
Since the recent approval of vaccines against COVID-19, efficacy concerns emerged for MS patients treated with immunosuppressive drugs. We report our experience in four patients, under cladribine (two) or under ocrelizumab (two) treatment, all with low lymphocyte count, three of them vaccinated after 3 months from the last dose with good immune response, one (under ocrelizumab) after 2 months, without developing an appropriate title of antibodies. This experience suggests that the discriminant for the response to the vaccine is not the lymphocyte count but the timing of the vaccination.
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