1. Breakthrough COVID-19 in people with multiple sclerosis on disease modifying treatments: Is it still a severe disease?
- Author
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Immovilli P, Schiavetti I, Franceschini A, De Mitri P, Gelati L, Rota E, and Guidetti D
- Subjects
- Humans, Female, Male, Middle Aged, Retrospective Studies, Adult, Immunologic Factors administration & dosage, Italy epidemiology, COVID-19 prevention & control, COVID-19 complications, Multiple Sclerosis drug therapy, COVID-19 Vaccines administration & dosage
- Abstract
Introduction: Disease modifying treatments (DMTs) for multiple sclerosis (MS) are effective in preventing both relapses and disability progression. Highly effective treatments (HETs) are more effective than platform therapy in preventing confirmed disability progression (CDP), when used early. Infections may complicate HETs administration, and their prevention through vaccination is crucial in order to assure the safety of people with MS (pwMS). The aim of the present study is to describe the effect of MS DMTs on COVID-19 vaccination and the risk of breakthrough infection in a cohort of pwMS., Materials and Methods: This is a monocentric retrospective observational study conducted at the MS center of the Guglielmo da Saliceto Hospital in Piacenza, Italy. One hundred and fifty-seven (157) pwMS who received two doses of the SARS-CoV-2 vaccine (with 80.3 % receiving a booster dose) were included in the study., Results: fifty-six pwMS (35.7 %) were females, the mean age was 48.6 (SD: 12.87) years, and 59 (37.6 %) had at least one comorbidity. Twenty-five (15.9 %) breakthrough infections were observed, with 17 (68.0 %) classified as mild and 8 (32.0 %) as moderate. A multivariable linear regression model confirmed that B-cell suppressor DMTs and EDSS were factors associated with the latest antibody titre. Patients treated with B-cell suppressors exhibited a risk almost four times higher for breakthrough infections compared to other patients, with a hazard ratio (HR) of 3.72 (95 % CI: 1.50 - 9.27) (p = 0.005)., Conclusions: B-cell suppressor DMTs are associated with the risk of breakthrough COVID-19 in our cohort, but vaccination fully protected pwMS against severe breakthrough disease., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Paolo Immovilli reports a relationship with Roche that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Merck & Co Inc that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Sanofi that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Janssen Pharmaceuticals Inc that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Bristol Myers Squibb Co that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Novartis that includes: speaking and lecture fees. Paolo Immovilli reports a relationship with Alexion that includes: speaking and lecture fees. Irene Schiavetti reports a relationship with Biogen that includes: consulting or advisory. Irene Schiavetti reports a relationship with Roche that includes: consulting or advisory. Irene Schiavetti reports a relationship with Horizon Therapeutics USA Inc that includes: speaking and lecture fees. Irene Schiavetti reports a relationship with Novartis that includes: consulting or advisory. Irene Schiavetti reports a relationship with Hoya Corporation that includes: consulting or advisory. Irene Schiavetti reports a relationship with Hippocrates Research that includes: consulting or advisory. Irene Schiavetti reports a relationship with DMG Italia SRL that includes: consulting or advisory. Irene Schiavetti reports a relationship with Eyepharma that includes: consulting or advisory. Irene Schiavetti reports a relationship with DreamsLab that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
- Published
- 2024
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