Investigating Effectiveness of COVID-19 Vaccination in Patients on B-Cell Depleting Therapies: Bruce Cree, MD, PhD, MAS, FAAN

WATCH TIME: 4 minutes

“I think it is important and also interesting that these antibodies that are being produced specifically by long lived plasma cells seem unaffected. It suggests that those cells are not the ones being targeted by the anti-CD19 and that fits in with our understanding of the long term, plasma cells that have probably lost CD19 from their surface.”

In June 2020, the FDA approved inebilizumab (Uplizna; Horizon) for the treatment of neuromyelitis optica spectrum disorder (NMOSD) based on findings from the N-MOmentum trial (NCT02200770).¹ N-MOmentum comprised of 231 patients with NMOSD, including those with and without AQP4-IgG antibodies, which occur in about 80% of patients with NMOSD. Over the course of the study, the risk of NMOSD relapse was reduced by 77% in the treatment group compared with placebo. Notably, no benefit was observed in patients who were anti-AQP4 antibody negative.

Following the approval, several analyses from the trial have been conducted, including two post hoc abstract posters that were presented at the 2023 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 23-25, in San Diego, California.^2,3 One analysis evaluated the correlations between treatment and COVID infection risk and outcomes, while the other explored whether long-term B-cell depletion in patients on inebilizumab affected antibody levels from childhood vaccinations.

During the forum, lead investigator Bruce Cree, MD, PhD, MAS, FAAN, sat down for an interview with NeurologyLive® to discuss the 2 post hoc analyses in detail. Cree, the clinical research director of the UCSF Multiple Sclerosis Center, also talked about the concerns surrounding anti-CD19 therapies in relation to hypogammaglobulinemia and plasma cells.

Click here for more coverage of ACTRIMS 2023.

REFERENCES
1. FDA Approves New Therapy for Rare Disease Affecting Optic Nerve, Spinal Cord. News release. FDA. June 11, 2020. Accessed March 2, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-new-therapy-rare-disease-affecting-optic-nerve-spinal-cord
2.Hartung H, Weinshenker B, Pittock S, et al. Effect of Inebilizumab on Vaccine-Generated Antibody Titers in NMOSD Participants: Results from N-MOmentum study. Presented at ACTRIMS Forum 2023; February 23-25; San Diego, California. Abstract P316.
3. Cree B, Rensel MR, Pittock S, et al. Clinical Outcomes of COVID-19 Infection Among Patients with NMOSD Receiving Inebilizumab Treatment in the N-Momentum Trial and Safety Database in the United State. Presented at ACTRIMS Forum 2023; February 23-25; San Diego, California. Abstract P314.