Loss of Antibody with anti-CD20 associated with poor COVID response


Bellinvia A, Aprea MG, Portaccio E, Pastò L, Razzolini L, Fonderico M, Addazio I, Betti M, Amato MP Hypogammaglobulinemia is associated with reduced antibody response after anti-SARS-CoV-2 vaccination in MS patients treated with antiCD20 therapies. .Neurol Sci. 2022:1-12. doi: 10.1007/s10072-022-06287-2. Online ahead of print

Background: COVID-19 vaccination is highly recommended to multiple sclerosis (MS) patients. Little is known about the role of patients’ clinical and demographic characteristics in determining antibody response.

Methods: We evaluated safety and efficacy of anti-SARS-CoV-2 vaccines on 143 included MS patients. Then, we analyzed antibody titer in a subgroup, assessing clinical and demographic variables associated with protection and antibody titer.

Results: After completing the vaccination cycle, the rate of local adverse events was similar after the first and second dose. A higher proportion of systemic AEs was reported after the second dose (65.7% vs 24.5% after the first dose). Antibody response was evaluated in 97 patients. Higher EDSS (OR 0.6, 95% CI 0.4-0.9, p = 0.006) and treatment with antiCD20 (OR 0.02, 95% CI 0.003-0.098, p 0.001) were associated with a lower chance of having an efficacious response. Higher weight was associated with higher Ab titer (β = 15.2, 95% CI 2.8-27.6, p = 0.017), while treatment with antiCD20 with lower titers (β = – 1092.3, 95% CI – 1477.4 to – 702.2, p < 0.001). In patients treated with antiCD20, hypogammaglobulinemia (β – 543, 95% CI – 1047.6 to – 39.1, p = 0.036) and treatment duration (β – 182, 95% CI – 341.4 to – 24.3, p = 0.027) were associated with lower Ab titer.

Conclusion: Our study confirms that COVID-19 vaccination in MS patient is safe and effective in preventing symptomatic COVID-19 and should be recommended to all patients. Moreover, we suggest a possible role of hypogammaglobulinemia in reducing Ab response in patients treated with antiCD20 therapies.

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  • Hi, I’m Suebee and I been using, an anticd20 for over 3 yrs. [welcome subee]. I’m afraid to stop using because I think it helps me perform better. Using has also impacted my life in a bad way: I am afraid to go anywhere in public. Rather than stop using, I had local hospital shoot me up 4x with anti-SARS-CoV-2 over past couple of years. CDC guidelines says users like me shouldn’t be tested for antibodies. But Using makes me desperate, so I gave up all rts to all my medical information in exchange for 3 antibody tests in a govt funded clinical study. ( Sometimes users make deals that don’t work out.) I have zero antibodies. Time, however, can make data separate the wheat from the chaff. 2x I lived with Covid infected household members but did not catch. I think my using with multiple negative PCRs made me stand out (visible). You scientists of world will be happy to know I got really generous offer for 5 more blood drawn antibody tests in exchange for a quick survey! Maybe they read your post Mousedoctor??! Race, weight, number of household members, employment, and education level achieved, I answered all. White, a bit chubby still cute, 3-5, no but a bit overeducated. (favorite survey question, “please indicate extent to which you view the pandemic as having Either positive or negative impact on your life”. 🙃 ) All kidding aside, the survey Didnt ask about ANY mitigation techniques. Mask type and use, air filtration, do I have a pod of friends, eat alfresco, frequent public places, use of curbside or home delivery of goods, travel for fun or business, number of times I go to a gym or medical facility a month. Scientists can do better. Please do better. But don’t take my word for it see https://doi.org/10.2105%2FAJPH.2016.303416
    That concludes,
    “studies of greatest consequence will be those that ask questions designed to enable intelligent policymaking.”
    Or just listen to Yogi Berra
    “You can observe a lot just by watching.”

  • Ehrrr… So what was I to gleam from this? Anti CD20, less antibody (we know). More exposure over time, less antibody (we know) Less response if heavier with same dose (we know, I think), safe (sure, we know), Hypogammaglobulinemia is associated with antibody loss. (Well, I assume something is happening to reduce B cells.) Effective? Where’s that? I’m not a med doc, so I assume there is a point here I have missed.

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