Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives

Bhise, Vikram; Dhib‐Jalbut, Suhayl

doi:10.1007/s13311-021-01008-7

Cited by 11 publications

(17 citation statements)

References 79 publications

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“…Regarding vaccine efficacy, especially in patients using therapies such as immunomodulatory and immunosuppressive drugs, a post-vaccination checkup is necessary forMS patients to make sure that the immunization has occurred properly [131] . If an adequate response isnot seen, it is recommended to add another booster vaccine [134] .…”

Section: Vaccination In Immunocompromised Patientsmentioning

confidence: 99%

Administration of COVID-19 vaccines in immunocompromised patients

Negahdaripour

Shafiekhani

Moezzi

et al. 2021

International Immunopharmacology

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Since the beginning of vaccination programs against COVID-19 in different countries, several populations such aspatients with specific immunological conditionshave been considered as the priorities for immunization. In this regard, patients with autoimmune diseases or those receiving immunosuppressive agents and anti-cancer therapies, need special attention. However, no confirmed data is presently available regarding COVID-19 vaccines in these populations due to exclusion from the conducted clinical trials. Given the probable suppression or over-activation of the immune system in such patients, reaching a consensus for their vaccination is critical, besides gathering data and conducting trials, which could probably clarify this matter in the future. In this review, besides a brief on the available COVID-19 vaccines, considerations and available knowledge about administering similar vaccines in patients with cancer, hematopoietic stem cell transplantation, solid organ transplantation, multiple sclerosis (MS), inflammatory bowel disease (IBD), and rheumatologic and dermatologic autoimmune disordersaresummarized to help in decision making. As discussed, live-attenuated viruses, which should be avoided in these groups, are not employed in the present COVID-19 vaccines. Thus, the main concern regarding efficacy could be met using a potent COVID-19 vaccine. Moreover, the vaccinationtiming for maximum efficacy could be decided according to the patient’scondition, indicated medications, and the guides provided here.Post-vaccination monitoring is also advised to ensure an adequate immune response. Further studies in this area are urgently warranted.

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Section: Vaccination In Immunocompromised Patientsmentioning

confidence: 99%

Administration of COVID-19 vaccines in immunocompromised patients

Negahdaripour

Shafiekhani

Moezzi

et al. 2021

International Immunopharmacology

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“…In this regard, monthly administered subcutaneous human B cell-depleting agent ofatumumab may offer the advantage of a shorter time span until CD19+ B cell repletion takes place ( 74 ). For ocrelizumab treatment, it is often suggested to vaccinate patients at the end of a treatment cycle with a minimum distance of four to six weeks to the next cycle ( 66 , 75 ). However, these experientially suggested time points need further confirmation in clinical studies.…”

Section: Vaccination Is Protective Yet Partly Less Effective Under Certain Dmtmentioning

confidence: 99%

Approach to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis

et al. 2021

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For more than a year now, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been causing the coronavirus disease (COVID-19) pandemic with high mortality and detrimental effects on society, economy, and individual lives. Great hopes are being placed on vaccination as one of the most potent escape strategies from the pandemic and multiple vaccines are already in clinical use. However, there is still a lot of insecurity about the safety and efficacy of vaccines in patients with autoimmune diseases like multiple sclerosis (MS), especially under treatment with immunomodulatory or immunosuppressive drugs. We propose strategic approaches to SARS-CoV-2 vaccination management in MS patients and encourage fellow physicians to measure the immune response in their patients. Notably, both humoral and cellular responses should be considered since the immunological equivalent for protection from SARS-CoV-2 after infection or vaccination still remains undefined and will most likely involve antiviral cellular immunity. It is important to gain insights into the vaccine response of immunocompromised patients in order to be able to deduce sensible strategies for vaccination in the future.

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“…Moreover, having an autoimmune disorder and for many, being on immunosuppressive or immunomodulatory therapies, theoretically poses a greater risk of COVID-19 infection. ( Bhise and Dhib-Jalbut, 2021 , Zheng et al, 2020 ) A higher level of health-related anxiety and self-isolation among individuals with MS during this time, thus, seems appropriate. In fact, over half of individuals with MS self-isolate at a greater rate than imposed by their government.…”

Section: Introductionmentioning

confidence: 96%

“…In this context, individuals with MS may be more susceptible to increased depression and anxiety during this time, whether due to relapse of existing symptom patterns or lower threshold for mental health symptoms. Moreover, having an autoimmune disorder and for many, being on immunosuppressive or immunomodulatory therapies, theoretically poses a greater risk of COVID-19 infection (Bhise and Dhib-Jalbut, 2021;Zheng et al, 2020). A higher level of health-related anxiety and self-isolation among individuals with MS during this time, thus, seems appropriate.…”

Section: Introductionmentioning

confidence: 99%

Surviving a global pandemic: The experience of depression, anxiety, and loneliness among individuals with multiple sclerosis

Strober¹,

Weber²,

Chiaravalloti³

2022

Multiple Sclerosis and Related Disorders

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Background The world has been experiencing one of the most significant worldwide health pandemics in modern history. The result has been increased depression, anxiety, and loneliness in the general population. However, populations who demonstrated pre-pandemic emotional disturbance and social isolation, such as individuals with multiple sclerosis (MS), are likely uniquely vulnerable to such symptoms. Objective The purpose of the present investigation was to examine the emotional outcomes, including reports of loneliness, in individuals with MS during the COVID-19 pandemic. We additionally sought to examine how individuals’ experiences during the pandemic may contribute to a specific COVID-19-related depression or anxiety. Methods 142 individuals with MS who previously participated in a national, online, survey-based study were asked to complete an online survey assessing their current level of depression, anxiety, loneliness, and perceived impact of the COVID-19 pandemic. Results Increases in the rates of depression and anxiety were noted, with approximately 54% and 33% reporting “new” depression or anxiety, respectively. Given this increase, we examined how individuals with “new” depression or anxiety differed from those without depression and anxiety and those with pre-pandemic depression and/or anxiety. Significant differences in person-specific factors (e.g., personality, self-efficacy) were noted between the groups. Increased loneliness was also found among both those with depression or anxiety regardless of whether “new” or pre-pandemic. Finally, all those depressed or anxious reported greater disruption and distress related to the COVID-19 pandemic with a trend for increased anxiety specifically related to the pandemic (e.g., fear or dying due to COVID-19) among those with new depression or anxiety when compared to those with existing depression or anxiety, suggesting an influence of the pandemic that is specific to reports of new depression or anxiety. Conclusion Findings suggest increased depression, anxiety, and loneliness among individuals with MS following the COVID-19 pandemic, with reports of “new” depression or anxiety, which appears to be related to the pandemic, specifically. Moreover, factors commonly associated with depression or anxiety in MS (e.g., personality, self-efficacy) were more common among those with existing depression or anxiety but not among those experiencing new depression or anxiety. These differences should be considered when attempting to ameliorate the impact of the COVID-19 among those experiencing emotional distress.

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Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives

Cited by 11 publications

References 79 publications

Administration of COVID-19 vaccines in immunocompromised patients

Administration of COVID-19 vaccines in immunocompromised patients

Approach to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis

Surviving a global pandemic: The experience of depression, anxiety, and loneliness among individuals with multiple sclerosis

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