MSCOVID19 Therapeutic Antibodies

M

This study shows what we have seen before and that is if people with fingolimod or ocrelizumab treatment who make a poor SARS-CoV-2 antibody response get infected. They get a therapeutic antibody and they all make a recovery. This bodes well for anti-virals as many of the therapeutic antibodies have issues because they can’t deal with omicrons

Manzano GS, Rice DR, Klawiter EC, Matiello M, Gillani RL, Tauhid SS, Bakshi R, Mateen FJ. Anti-SARS-CoV-2 monoclonal antibodies for the treatment of active COVID-19 in multiple sclerosis: An observational study. Mult Scler. 2022 Apr 27:13524585221092309. 

Monoclonal antibodies (mAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) received emergency use authorization for the acute treatment of COVID-19. We are not aware of published data on their use in immunosuppressed people with multiple sclerosis (pwMS). We report 23 pwMS (mean age = 49 years, ocrelizumab (n = 19), fingolimod (n = 2), vaccinated with at least an initial series (n = 19)) who received mAb for acute COVID-19. Following mAb receipt, approximately half recovered in <7 days (48%). There were no adverse events or deaths. Use of mAb for pwMS treated with fingolimod or ocrelizumab was not observed to be harmful and is likely helpful for treatment of acute COVID-19.

Background: The effect of disease-modifying therapies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine response is unclear.

Objectives: We aim to determine the immunological responses to SARS-CoV-2 in multiple sclerosis (MS) and anti-CD20-treated patients with other autoimmune diseases (AID).

Methods: Humoral and cellular responses we determined before and 30-90 days after vaccination in patients with MS and anti-CD20-treated patients with other AID in two Catalan centers.

Results: 457 patients were enrolled. Findings showed that humoral response decreased under anti-CD20s or sphingosine 1-phosphate receptor modulators (S1PRM) and with longer treatment duration and increased after 4.5 months from the last anti-CD20 infusion. Cellular response decreased in S1PRM-treated. Patients on anti-CD20 can present cellular responses even in the absence of antibodies.

Conclusion: Anti-CD20s and S1PRM modify the immunological responses to SARS-CoV-2 vaccines.

Zabalza et al. Is humoral and cellular response to SARS-CoV-2 vaccine modified by DMT in patients with multiple sclerosis and other autoimmune diseases? Mult Scler. 2022 :13524585221089540

Background: The effect of disease-modifying therapies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine response is unclear (Really? Should have gone to Spec Savers).

Objectives: We aim to determine the immunological responses to SARS-CoV-2 in multiple sclerosis (MS) and anti-CD20-treated patients with other autoimmune diseases (AID).

Methods: Humoral and cellular responses we determined before and 30-90 days after vaccination in patients with MS and anti-CD20-treated patients with other AID in two Catalan centers.

Results: 457 patients were enrolled. Findings showed that humoral response decreased under anti-CD20s or sphingosine 1-phosphate receptor modulators (S1PRM) and with longer treatment duration and increased after 4.5 months from the last anti-CD20 infusion. Cellular response decreased in S1PRM-treated. Patients on anti-CD20 can present cellular responses even in the absence of antibodies.

Conclusion: Anti-CD20s and S1PRM modify the immunological responses to SARS-CoV-2 vaccines.

So nothing new here but another 500 people indicates that the original observations are robust

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MouseDoctor

3 comments

  • Mousedoctor, as always, I am very appreciative of you and keeping us pwms informed, especially when our immune status is generally treated with ambivalence. I report, at least antidotally, that getting access to antivirals in US if one is a mobile <60 year old pwms is dependent on self advocacy, computer access to find provider, insurance approval, and luck. Here is best US antiviral map finder I keep on hand. I cross checked accuracy with my own state data, and it was spot on. Wishing you all good health. http://www.gregorytravis.com/SARS-CoV-2/CoronaGraphs/therafind.php

  • “Use of mAb for pwMS treated with fingolimod or ocrelizumab was not observed to be harmful and is likely helpful for treatment of acute COVID-19.”

    One problem of the newbie is the natural hope for normalcy in their life. From what I read on some of the Facebook sites, these newbies gave little thought to associated risks and their prescribing doctors may not have looked too hard to be certain- the degree of their patient’s understanding. Many did not do OK with a covid infection and they were not happy about it. So it’s good that there is a treatment that can come to the rescue when needed. The question then becomes (one of them), what led to their bad outcome with covid, and especially, how often are they going to repeat the need for this treatment? Still, do they yet even realize the repeat nature of the threat? And backing out (at least with ocrelizumab), is much easier said than done.

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