Ofatumumab and COVID-19 vaccination


The SH1 stuck to rituximab and ocrelizumab for inducing a poor response to COVID-19-related vaccines…because they were being used alot during the pandemic. Ofatumumab avoided the bad news as it want’t used as much but as it could be given at home and thus avoided a trip into hosptial for treatment. The Dresden group has been at the forfront of looking at the influence of DMT on SARS-CoV-2 vaccines and here they look at the influence of ofatumumab.

Vaccine before anti-CD20 should work no problem as it works with rituximab and ocrelizumab but what about vaccination after ofatumumab. There was inhibition in the antibody level but many people converted. This makes on ask can you have it both ways. If it is not that great at stopping vaccine responses is it that great at stopping B cell function? Remember it seems that the Elecsys system is good at seeing positive responses.

Ziemssen T, Schlegel E, Groth M, Ettle B, Bopp T. Results on SARS-CoV-2 mRNA Vaccine Booster from an Open-Label Multicenter Study in Ofatumumab-Treated Participants with Relapsing Multiple Sclerosis. Vaccines (Basel). 2023;11(5):978. 

Background: Few data exist on how ofatumumab treatment impacts SARS-CoV-2 booster vaccination response.

Methods: KYRIOS is an ongoing prospective open-label multicenter study on the response to initial and booster SARS-CoV-2 mRNA vaccination before or during ofatumumab treatment in relapsing MS patients. The results on the initial vaccination cohort have been published previously. Here, we describe 23 patients who received their initial vaccination outside of the study but booster vaccination during the study. Additionally, we report the booster results of two patients in the initial vaccination cohort. The primary endpoint was SARS-CoV-2-specific T-cell response at month 1. Furthermore, serum total and neutralizing antibodies were measured.

Results: The primary endpoint was reached by 87.5% of patients with booster before (booster cohort 1, N = 8) and 46.7% of patients with booster during ofatumumab treatment (booster cohort 2, N = 15). Seroconversion rates for neutralizing antibodies increased from 87.5% at baseline to 100.0% at month 1 in booster cohort 1 and from 71.4% to 93.3% in booster cohort 2. Of note, 3 of 4 initially seronegative patients in booster cohort 2 and one seronegative patient in the initial vaccination cohort seroconverted after the booster during ofatumumab treatment.

Conclusions: Booster vaccinations increase neutralizing antibody titers in ofatumumab-treated patients. A booster is recommended in ofatumumab-treated patients.

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    • It is clear that anti-CD20 can inhiit the vaccine response and this may just be toreduce the antibody level….but the vrus is one step ahead of us and the circulating variants have viral escape meaning you have to have high levels to stop infection, so repeated COVID infections are the way it is going to be the value of the vaccines ae that you can get rid of the virus, before it gets rid of you.

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