Reduced antibody formation after influenza vaccination in patients with neuromyelitis optica spectrum disorder treated with rituximab

Kim, W.; Kim, S.-H.; Huh, So Young; Kong, Sun Young; Choi, Young Ju; Cheong, Hee Jin; Kim, H. J.

doi:10.1111/ene.12132

Cited by 53 publications

(43 citation statements)

References 26 publications

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“…Interestingly, this patient had previously received 2 previous rounds of rituximab. This finding is supported by a previous study in which patients who had previously received maintenance rituximab monotherapy to treat neuromyelitis optica appeared to have blunted vaccine responses (32), suggesting that repeat dosages or rituximab may be associated with poor influenza vaccine efficacy. It is possible that the repeat treatments caused a more complete depletion, specifically in lymphoid tissues, which could explain the lack of plasmablast response.…”

Section: Discussionsupporting

confidence: 78%

“…To our knowledge, there are no reports describing vaccine efficacy in rituximab-treated AIBD patients. Previous studies have reported severely impaired immune responses to influenza vaccination in other types of rituximab-treated patients, primarily RA or lymphoma patients (30)(31)(32)(33)(34). A major caveat to these earlier studies is that patients were treated with concomitant immunosuppressive drugs or chemotherapy, making it difficult to determine the effect of the individual drugs on vaccine responses.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Robust memory responses against influenza vaccination in pemphigus patients previously treated with rituximab

Cho¹,

Bradley²,

Kauffman³

et al. 2017

JCI Insight

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Robust memory responses against influenza vaccination in pemphigus patients previously treated with rituximab

Cho¹,

Bradley²,

Kauffman³

et al. 2017

JCI Insight

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“…However, in the present study, no patient developed PML during a further 1-year follow-up since the second set of samples was obtained. Moreover, although depleting B cells following rituximab treatment seems to reduce the humoral immune response to neoantigen, certain proportion of patients treated with rituximab did respond to the influenza vaccine despite total B cell depletion [19,20].…”

Section: Discussionmentioning

confidence: 99%

Anti-JC virus antibodies in rituximab-treated patients with neuromyelitis optica spectrum disorder

et al. 2015

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Rituximab, a chimeric monoclonal anti-CD20 antibody, has been proposed to be effective for neuromyelitis optica spectrum disorder (NMOSD). A concern for developing progressive multifocal leukoencephalopathy (PML), which is caused by John Cunningham virus (JCV), has been suggested particularly in patients treated long term with rituximab. In this study, using a modified enzyme-linked immunosorbent assay with glutathione S-transferase-tagged VP1 as the antigen, we investigated the seroprevalence of anti-JCV antibodies among 78 Korean patients with NMOSD and the change in anti-JCV antibody serostatus following long-term rituximab treatment. The overall seroprevalence of anti-JCV antibodies was 69 % prior to rituximab administration. Over a mean of 4 years of repeated treatment with rituximab, no patient developed PML. Of 24 initially seronegative patients, none converted into seropositive, whereas six (11 %) of 54 initially seropositive patients converted into seronegative. Our results might support the safety of long-term rituximab treatment in patients with NMOSD with regard to the risk of developing PML.

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“…Progressive multifocal leukoencephalopathy is another potential complication, which has not yet been reported in patients with NMOSD or MS treated with rituximab. Vaccinations with inactivated vaccines are safe during rituximab therapy in patients with NMOSD, but a reduction in the immune response should be anticipated [113].…”

Section: Rituximab and Other B-cell-depleting Therapiesmentioning

confidence: 99%

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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Neuromyelitis optica spectrum disorders (NMOSD) are important evolving entities, which have reached much attention in the recent years. NMOSD are characterized by inflammatory lesions in the optic nerves, spinal cord, and central parts of the brain, as well as an autoimmune process directed against aquaporin-4. As disability in NMOSD accumulates by inflammatory damage from attacks, both the treatment and prevention of attacks are decisive for the long-term outcome. NMOSD attacks are treated with highdose intravenous corticosteroids and apheresis therapies, in particular therapeutic plasma exchange. In cases of incomplete remission, escalation of attack treatment is recommended. Preventive therapy is immunosuppressive and should by commenced as early as possible. Apart from classical immunosuppressants such as azathioprine and mycophenolate mofetil, repurposed biologicals are increasingly used. B-cell depletion with rituximab and other agents, inhibition of the interleukin-6 receptor with tocilizumab, and blockade of complement-mediated damage by eculizumab all are promising therapeutic strategies evaluated in randomized controlled trials. In this review, we will discuss present and future immunotherapies for NMOSD and also consider combination of treatments, plasma, cellular and other therapies. Current advances in immunopathological knowledge are translated into innovative concepts and begin a new era of NMOSD therapy.

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Reduced antibody formation after influenza vaccination in patients with neuromyelitis optica spectrum disorder treated with rituximab

Abstract: This study shows a severely hampered humoral immune response to H1N1 influenza vaccine in patients with NMOSD treated with rituximab, although the vaccination itself is safe in these patients.

Cited by 53 publications

References 26 publications

Robust memory responses against influenza vaccination in pemphigus patients previously treated with rituximab

Robust memory responses against influenza vaccination in pemphigus patients previously treated with rituximab

Anti-JC virus antibodies in rituximab-treated patients with neuromyelitis optica spectrum disorder

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

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