scholarly journals COVID-19 Vaccine Failure in a Patient with Multiple Sclerosis on Ocrelizumab

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 219
Author(s):  
Sridhar Chilimuri ◽  
Nikhitha Mantri ◽  
Sudharsan Gongati ◽  
Maleeha Zahid ◽  
Haozhe Sun
Keyword(s):  
Multiple Sclerosis ◽  
B Cell ◽  
Vaccine Efficacy ◽  
Limited Data ◽  
Vaccine Response ◽  
Vaccine Failure ◽  
Safety And Efficacy ◽  
First Case ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Vaccines will play a key role in ending the COVID-19 pandemic. Vaccination against infections remains an important part of the management of patients with multiple sclerosis. However, there are limited data about the safety and efficacy of the currently available COVID-19 mRNA vaccines in patients with multiple sclerosis receiving concurrent immunosuppressive therapies. Patients on B cell depleting therapy such as ocrelizumab have an attenuated vaccine response. We report the first case of COVID-19 vaccine failure in a patient with relapsing-remitting multiple sclerosis on B cell depleting therapy, ocrelizumab. We offer suggestions to improve vaccine efficacy in these patients.

Cladribine transfer into human milk: A case report

2020 ◽  
pp. 135245852091217
Author(s):  
Palika Datta ◽  
Andrea I Ciplea ◽  
Kathleen Rewers-Felkins ◽  
Teresa Baker ◽  
Ralf Gold ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mass Spectrometry ◽  
Case Report ◽  
Human Milk ◽  
Liquid Chromatography Mass Spectrometry ◽  
Milk Samples ◽  
First Case ◽  
Relapsing Remitting ◽  
Infant Dose ◽  
Relapsing Remitting Multiple Sclerosis

Background: Cladribine is an antimetabolite used for the treatment of relapsing–remitting multiple sclerosis. At present, there are no data available on its use in breastfeeding mothers and its transfer in human milk. Objective: We present a case of a lactating mother who donated her milk samples to study the transfer of cladribine following a 20-mg oral dose. Methods: Analysis was done using liquid chromatography–mass spectrometry. Results: The relative infant dose calculated in this study was 3.06%. Conclusion: This is the first case report suggesting the transfer of cladribine in human milk in measurable quantities. However, caution should be advised during lactation.

scholarly journals Safety and Efficacy of Siponimod (BAF312) in Patients With Relapsing-Remitting Multiple Sclerosis

2016 ◽  
Vol 73 (9) ◽  
pp. 1089 ◽  
Author(s):  
Ludwig Kappos ◽  
David K. B. Li ◽  
Olaf Stüve ◽  
Hans-Peter Hartung ◽  
Mark S. Freedman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Safety And Efficacy ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

scholarly journals B cell depletion can be effective in multiple sclerosis but failed in a patient with advanced childhood cerebral X-linked adrenoleukodystrophy

2019 ◽  
Vol 12 ◽  
pp. 175628641986813
Author(s):  
Hendrik Rosewich ◽  
Stefan Nessler ◽  
Wolfgang Brück ◽  
Jutta Gärtner
Keyword(s):  
Multiple Sclerosis ◽  
B Cell ◽  
B Lymphocytes ◽  
Specific Pattern ◽  
B Cell Depletion ◽  
Compassionate Use ◽  
Clinical Imaging ◽  
Relapsing Remitting ◽  
Advanced Stages ◽  
Relapsing Remitting Multiple Sclerosis

Rituximab exerts its clinical efficacy by its specific pattern of depletion of CD20+ B lymphocytes and it has been demonstrated that rituximab is an effective treatment for relapsing remitting multiple sclerosis. X-linked adrenoleukodystrophy (X-ALD), the most common monogenetic neuroinflammatory disorder, shares substantial overlap with multiple sclerosis in the neuropathological changes found in brain tissues in advanced stages of the disease. While there is no effective therapy for these patients, we hypothesized that rituximab might be effective in arresting the neuroinflammatory process. Our detailed clinical, imaging and immunological data revealed that rituximab is not effective in advanced stages of X-ALD and consequently should not be applied for compassionate use in these patients.

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