scholarly journals Impact of Disease-Modifying Treatments of Multiple Sclerosis on Anti–SARS-CoV-2 Antibodies

2021 ◽  
Vol 8 (5) ◽  
pp. e1055
Author(s):  
Kévin Bigaut ◽  
Laurent Kremer ◽  
Thibaut Fabacher ◽  
Livia Lanotte ◽  
Marie-Celine Fleury ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Recurrent Infection ◽  
Humoral Response ◽  
Interferon Β ◽  
Igg Index ◽  
Disease Modifying ◽  
Anti Cd20 ◽  
Class Iv

ObjectiveTo compare the humoral response after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with multiple sclerosis (MS) receiving different disease-modifying treatments (DMTs).MethodsPatients with MS with coronavirus disease 2019 (COVID-19) and available anti–SARS-CoV-2 serology were included. The primary endpoint was the anti–SARS-CoV-2 immunoglobulin G (IgG) index. The multivariate analysis was adjusted for COVID-19 severity, SARS-CoV-2 PCR result, and the time between COVID-19 onset and the serology.ResultsWe included 61 patients with available IgG index. The IgG index was lower in patients with fingolimod or anti-CD20 monoclonal antibodies compared with patients without treatment (p < 0.01), patients with interferon β-1a or glatiramer (p < 0.01), and patients with another DMT (p = 0.01). The IgG index was correlated with the time between COVID-19 onset and serology (r = −0.296 [−0.510; −0.0477], p = 0.02).ConclusionsHumoral response after COVID-19 was lower in patients with MS with fingolimod or anti-CD20 mAb. These patients could therefore be at risk of recurrent infection and could benefit from anti–SARS-CoV-2 vaccination. The humoral response after vaccination and the delay before vaccination need to be evaluated.Classification of EvidenceThis study provides Class IV evidence that patients treated with fingolimod or anti-CD20 monoclonal antibodies for MS have a lower humoral response after COVID-19 compared with patients without DMTs or with another DMTs.

Extended dosing of monoclonal antibodies in multiple sclerosis

2021 ◽  
pp. 135245852110657
Author(s):  
Zoé LE van Kempen ◽  
Alyssa A Toorop ◽  
Finn Sellebjerg ◽  
Gavin Giovannoni ◽  
Joep Killestein
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Treatment Options ◽  
Future Research ◽  
Therapeutic Drug ◽  
Therapeutic Landscape ◽  
Anti Cd20 ◽  
Dosing Intervals ◽  
Care Costs ◽  
Review Current

Over the past two decades, treatment options for patients with multiple sclerosis (MS) have increased exponentially. In the current therapeutic landscape, “no evidence of MS disease activity” is within reach in many of our patients. Minimizing risks of complications, improving treatment convenience, and decreasing health care costs are goals that are yet to be reached. One way to optimize MS therapy is to implement personalized or extended interval dosing. Monoclonal antibodies are suitable candidates for personalized dosing (by therapeutic drug monitoring) or extended interval dosing. An increasing number of studies are performed and underway reporting on altered dosing intervals of anti-α4β1-integrin treatment (natalizumab) and anti-CD20 treatment (ocrelizumab, rituximab, and ofatumumab) in MS. In this review, current available evidence regarding personalized and extended interval dosing of monoclonal antibodies in MS is discussed with recommendations for future research and clinical practice.

scholarly journals Multiple sclerosis: disease modifying therapy and the human leukocyte antigen

2018 ◽  
Vol 76 (10) ◽  
pp. 697-704 ◽  
Author(s):  
Lineu Cesar Werneck ◽  
Paulo José Lorenzoni ◽  
Cláudia Suemi Kamoi Kay ◽  
Rosana Herminia Scola
Keyword(s):  
Multiple Sclerosis ◽  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Class I ◽  
Interferon Β ◽  
Leukocyte Antigen ◽  
Specific Subset ◽  
Hla Type ◽  
Disease Modifying

ABSTRACT Objective: To investigate the potential relationship between the human leukocyte antigen (HLA) type (class I and II) and the response to several disease-modifying therapies (DMTs) in patients with multiple sclerosis (MS). Methods: We analyzed clinical data of 87 patients with MS at the beginning and end of each type of DMT including the disease duration, Expanded Disability Status Scale and Multiple Sclerosis Severity Score (MSSS). Genotyping of HLA-DRB1, HLA-DPB1, HLA-DQB1, HLA-A, HLA-B and HLA-C alleles were identified using high-resolution techniques. Statistical correlation between the HLA type and response to DMTs was done using the initial and final MSSS. Results: Statistical relationships (p < 0.05) were found for only 15 of 245 alleles tested. There was a reduction in the MSSS for patients treated with corticosteroids (DRB1*15:01, DPB1*04:01, DQB1*02:01 and DQB1*03:01), azathioprine (DRB1*03:01, DPB1*04:01, DQB1*03:02, DQB1*06:02, HLA-C*07:02), interferon β-1a 22 mcg (DRB1*11:04, DQB1*03:01 and DQB1*03:02), interferon β-1a 30 mcg (DPB1*02:01, HLA-C*05:01) and interferon β-1b (DQB1*02:01). Conclusion: These findings suggest a few relationships between the HLA and response to DMTs in the disability for some types of HLA class I and II alleles in a specific subset of MS patients.

Anti-CD20 monoclonal antibodies in multiple sclerosis

2016 ◽  
Vol 17 (4) ◽  
pp. 359-371 ◽  
Author(s):  
Irene Moreno Torres ◽  
Antonio García-Merino
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Anti Cd20

Natalizumab (Tysabri) in multiple sclerosis patients

2008 ◽  
Vol 9 (2) ◽  
pp. 109-114
Author(s):  
Viola Sacchi
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Symptom Relief ◽  
Interferon Β ◽  
Disease Modifying Therapies ◽  
Mental Symptoms ◽  
The Central Nervous System ◽  
Disease Modifying ◽  
Multiple Sclerosis Patients ◽  
Immunomodulating Drugs

Multiple sclerosis (MS) is an autoimmune disease where dysregulated immune system elements (i.e. leucocytes) react against different components of the central nervous system (CNS), in particular myelin structures, causing several physical and mental symptoms,often progressing to total disability. While some treatments for MS provide only symptom relief, the most commonly drugs administered for altering the course of the disease are DMTs (disease-modifying therapies); nevertheless for more than ten years the only DMTs available were interferon β, glatiramer acetate (two immunomodulating drugs) and mitoxantrone (an immunosuppressant).

IV steroids during long episodes of Kleine-Levin syndrome

Neurology ◽  
2018 ◽  
Vol 90 (17) ◽  
pp. e1488-e1492 ◽  
Author(s):  
Antoine Léotard ◽  
Elisabeth Groos ◽  
Charlotte Chaumereuil ◽  
Laure Peter-Derex ◽  
Andrea O. Rossetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Effects ◽  
Risk Ratio ◽  
Muscle Pain ◽  
Disease Duration ◽  
Naturalistic Study ◽  
Previous Episode ◽  
Episode Duration ◽  
Class Iv

ObjectiveTo retrospectively compare the benefits (episode cessation) and risks of IV methylprednisolone (IV-MP) vs abstention during prolonged Kleine-Levin syndrome (KLS) episodes.MethodsA total of 26 patients with KLS received 1 g/d IV-MP for 3 days during 1 to 6 episodes each (totaling 43 IV-MP sessions). The change of episode duration with IV-MP (vs previous episode duration) was compared with the change duration between 2 consecutive episodes in 48 untreated patients matched for age, sex, age at KLS onset, number of episodes, and disease duration (more treated than untreated patients had long episodes).ResultsEleven patients (42.3%) had an episode that was at least 1 week shorter than the preceding one when they received IV-MP therapy, whereas shorter episodes were significantly less frequent (10.4%) in the untreated group. This benefit was more marked (65.5% responders, 12 fewer days in an episode vs 0 days in the untreated patients) when IV-MP was infused before the 10th day of the episode. Mild, transient adverse effects (insomnia, muscle pain, nervousness/restlessness, but no manic switching) were reported by 61.3% of patients. No specific responder profile was identified.ConclusionIn this open-labeled, naturalistic study, early IV-MP (following the protocol for multiple sclerosis relapses) had a good benefit/risk ratio during KLS episodes in patients with long episodes (with half of the patients having an early cessation of episodes).Classification of evidenceThis study provides Class IV evidence that for patients with long episodes of KLS, IV steroids decrease the duration of KLS episodes.

Multiple Sclerosis

2019 ◽  
pp. 59-100
Author(s):  
Gary Birnbaum
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Stem Cell ◽  
Plasma Exchange ◽  
Practical Approach ◽  
Oral Disease ◽  
Adult Onset ◽  
Experimental Therapies ◽  
Disease Modifying ◽  
Underlying Pathology

This chapter provides a broad overview of adult onset multiple sclerosis (MS), with the intent of providing a practical approach to diagnosis and treatments. It starts by looking at the epidemiology and demographics of MS, followed by a detailed discussion of the pathogenesis and pathology of MS. The chapter discusses the diagnosis, the various stages, and the symptoms of MS. Treatment of the disease, addressing both underlying pathology and symptoms, are discussed in detail. These include discussions of established therapies such as injectable and oral disease-modifying therapies, monoclonal antibodies, plasmapheresis or plasma exchange (PLEX), as well as new, and currently experimental therapies such as autologous stem cell transplants. Emphasis is especially directed at the often-underutilized management of MS-related symptoms.

Anti-CD20 Monoclonal Antibodies for Relapsing and Progressive Multiple Sclerosis

CNS Drugs ◽  
2020 ◽  
Vol 34 (3) ◽  
pp. 269-280 ◽  
Author(s):  
Finn Sellebjerg ◽  
Morten Blinkenberg ◽  
Per Soelberg Sorensen
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
Progressive Multiple Sclerosis ◽  
Anti Cd20

scholarly journals A Milestone in Multiple Sclerosis Therapy: Monoclonal Antibodies Against CD20—Yet Progress Continues

2021 ◽  
Author(s):  
Esther S. Frisch ◽  
Roxanne Pretzsch ◽  
Martin S. Weber
Keyword(s):  
Multiple Sclerosis ◽  
Monoclonal Antibodies ◽  
B Cells ◽  
B Cell ◽  
Current Knowledge ◽  
Disease Onset ◽  
Chronic Inflammatory Disease ◽  
Targeting Therapy ◽  
Long Term Treatment ◽  
Anti Cd20

AbstractMultiple sclerosis (MS), which is a chronic inflammatory disease of the central nervous system, still represents one of the most common causes of persisting disability with an early disease onset. Growing evidence suggests B cells to play a crucial role in its pathogenesis and progression. Over the last decades, monoclonal antibodies (mabs) against the surface protein CD20 have been intensively studied as a B cell targeting therapy in relapsing MS (RMS) as well as primary progressive MS (PPMS). Pivotal studies on anti-CD20 therapy in RMS showed remarkable clinical and radiological effects, especially on acute inflammation and relapse biology. These results paved the way for further research on the implication of B cells in the pathogenesis of MS. Besides controlling relapse development in RMS, ocrelizumab (OCR) also showed clinical benefits in patients with PPMS and became the first approved drug for this disease course. In this review, we provide an overview of the current anti-CD20 mabs used or tested for the treatment of MS—namely rituximab (RTX), OCR, ofatumumab (OFA), and ublituximab (UB). Besides their effectiveness, we also discuss possible limitations and safety concerns especially in regard to long-term treatment, both for this class of drugs overall as well as for each anti-CD20 mab individually. Additionally, we elucidate to what extent anti-CD20 therapy may alter the function of other immune cells, both directly or indirectly. Finally, we cover the current knowledge on repopulation of CD20+ cells after cessation of anti-CD20 treatment and discuss future aspirations towards alternative, further developed B cell silencing therapies.

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