Although most autoimmune diseases are considered to be CD4 T cell- or antibody-mediated, many respond to CD20-depleting antibodies that have limited influence on CD4 and plasma cells. This includes rituximab, oblinutuzumab and ofatumumab that are used in cancer, rheumatoid arthritis and off-label in a large number of other autoimmunities and ocrelizumab in multiple sclerosis. Recently, the COVID-19 pandemic created concerns about immunosuppression in autoimmunity, leading to cessation or a delay in immunotherapy treatments. However, based on the known and emerging biology of autoimmunity and COVID-19, it was hypothesised that while B cell depletion should not necessarily expose people to severe SARS-CoV-2-related issues, it may inhibit protective immunity following infection and vaccination. As such, drug-induced B cell subset inhibition, that controls at least some autoimmunities, would not influence innate and CD8 T cell responses, which are central to SARS-CoV-2 elimination, nor the hypercoagulation and innate inflammation causing severe morbidity. This is supported clinically, as the majority of SARS-CoV-2-infected, CD20-depleted people with autoimmunity have recovered. However, protective neutralizing antibody and vaccinat...Continue Reading
Associated Clinical Trials
Antibodies Production After Covid-19 Vaccination Among Patients With Medical History of Cancer and Anti-CD-20 Treatment
Antigenic cross-reactivity between severe acute respiratory syndrome-associated coronavirus and human coronaviruses 229E and OC43
Regeneration of B cell subsets after transient B cell depletion using anti-CD20 antibodies in rheumatoid arthritis
Immunization responses in rheumatoid arthritis patients treated with rituximab: results from a controlled clinical trial
Patients with humoral primary immunodeficiency do not develop protective anti-influenza antibody titers after vaccination with trivalent subunit influenza vaccine
Repeated treatment with rituximab based on the assessment of peripheral circulating memory B cells in patients with relapsing neuromyelitis optica over 2 years
Reduced antibody formation after influenza vaccination in patients with neuromyelitis optica spectrum disorder treated with rituximab
Virus-specific memory CD8 T cells provide substantial protection from lethal severe acute respiratory syndrome coronavirus infection
Usefulness of monitoring of B cell depletion in rituximab-treated rheumatoid arthritis patients in order to predict clinical relapse: a prospective observational study
Safety and immunogenicity of inactivated varicella-zoster virus vaccine in adults with hematologic malignancies receiving treatment with anti-CD20 monoclonal antibodies
Robust memory responses against influenza vaccination in pemphigus patients previously treated with rituximab
Efficacy and safety of teriflunomide in Asian patients with relapsing forms of multiple sclerosis: A subgroup analysis of the phase 3 TOWER study
Effect of rituximab treatment on T and B cell subsets in lymph node biopsies of patients with rheumatoid arthritis
Effect of cladribine tablets on lymphocyte reduction and repopulation dynamics in patients with relapsing multiple sclerosis
Infection Risks Among Patients With Multiple Sclerosis Treated With Fingolimod, Natalizumab, Rituximab, and Injectable Therapies.
Interrupting rituximab treatment in relapsing-remitting multiple sclerosis; no evidence of rebound disease activity
Event-Driven Immunoprofiling Predicts Return of Disease Activity in Alemtuzumab-Treated Multiple Sclerosis.
Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies.
Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic.
Evaluation of the immune response to hepatitis B vaccine in patients on biological therapy: results of the RIER cohort study
Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases.
Authors' reply to the comment "Treatment considerations for patients with pemphigus during the COVID-19 pandemic"
Patient perspective on decisions to switch disease-modifying treatments in relapsing-remitting multiple sclerosis.
Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives.
Assessing and mitigating risk of infection in patients with multiple sclerosis on disease modifying treatment.
Position statement for a pragmatic approach to immunotherapeutics in patients with inflammatory skin diseases during the coronavirus disease 2019 pandemic and beyond.
COVID-19 and disease-modifying therapies in patients with demyelinating diseases of the central nervous system: A systematic review.
Influence of delaying ocrelizumab dosing in multiple sclerosis due to COVID-19 pandemics on clinical and laboratory effectiveness.
Negative anti-SARS-CoV-2 S antibody response following Pfizer SARS-CoV-2 vaccination in a patient on ocrelizumab.
A practical approach for vaccinations including COVID-19 in autoimmune/autoinflammatory rheumatic diseases: a non-systematic review.
More difficult still: Treating severe rapidly progressive glomerulonephritis in the context of COVID-19 pneumonia.
COVID-19 Vaccination in Patients with Autoimmune Inflammatory Rheumatic Diseases: Clinical Guidance of the Korean College of Rheumatology.
COVID-19 vaccination hesitancy in patients with autoimmune diseases: A mystery that needs an immediate solution!
How to Manage COVID-19 Vaccination in Immune-Mediated Inflammatory Diseases: An Expert Opinion by IMIDs Study Group.
Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases.
Acute relapse and poor immunization following COVID-19 vaccination in a rituximab-treated multiple sclerosis patient.
American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 1.
Reduced humoral response to mRNA SARS-CoV-2 BNT162b2 vaccine in kidney transplant recipients without prior exposure to the virus: No cause for alarm.
The Significance of COVID-19 Immunological Status in Severe Neurological Complications and Multiple Sclerosis-A Literature Review.
Negative SARS-CoV2-antibodies after positive COVID-19-PCR nasopharyngeal swab in patients treated with anti-CD20 therapies.
Personalizing ocrelizumab treatment in Multiple Sclerosis: What can we learn from Sars-Cov2 pandemic?
Vaccinations in Patients Receiving Systemic Drugs for Skin Disorders: What Can We Learn for SARS-Cov-2 Vaccination Strategies?
American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 2.
Successful Clearance of 300 Day SARS-CoV-2 Infection in a Subject with B-Cell Depletion Associated Prolonged (B-DEAP) COVID by REGEN-COV Anti-Spike Monoclonal Antibody Cocktail.
Update on the management of multiple sclerosis during the COVID-19 pandemic and post pandemic: An international consensus statement.
Immunization in multiple sclerosis and other childhood immune-mediated disorders of the central nervous system: A review of the literature.
Impact of SARS-CoV-2 variants on the total CD4+ and CD8+ T cell reactivity in infected or vaccinated individuals.
Re-infection with a different SARS-CoV-2 clade and prolonged viral shedding in a hematopoietic stem cell transplantation patient.
Clinical Trials Mentioned
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