Ocrelizumab Decreases Humoral Response to 4 Vaccines in Multiple Sclerosis

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Vaccinations against infections are an important part of the management of patients with multiple sclerosis.
Vaccinations against infections are an important part of the management of patients with multiple sclerosis.
The following article is part of conference coverage from the 2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers in Nashville, Tennesssee. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2018.

Ocrelizumab decreases the humoral response of individuals with multiple sclerosis to 4 vaccines: keyhole limpet hemocyanin, influenza, pneumococcal polysaccharide, and tetanus, according to research presented at the 32nd Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 30-June 2, in Nashville, Tennessee.

The VELOCE trial (ClinicalTrials.gov Identifier: NCT02545868) was an open-label, randomized, phase 3b study designed to assess whether ocrelizumab could raise the humoral responses to vaccines in individuals with relapsing multiple sclerosis. 

Researchers randomly assigned 102 subjects into Group A (n=68), which was subdivided into A1 (n=33) and A2 (n=35) and given a single dose of ocrelizumab 600 mg, and Group B (n=34), which served as a control. All study participants received keyhole limpet hemocyanin, a tetanus toxoid-containing vaccine, and a 23-valent pneumococcal polysaccharide vaccine. Group A1 also received a pneumococcal booster at 4 weeks after the initial pneumococcal vaccine, and Group A2 also received a vaccine for seasonal influenza. Group B (control) received the same vaccinations as A2, but starting on day 1, while participants in Group A were not vaccinated until 12 weeks after ocrelizumab initiation.

At 4 weeks, 71% of Group A and 100% of Group B showed a positive response to at least 5 serotypes in the 23-valent pneumococcal polysaccharide vaccine. The booster vaccine given to Group A1 did not increase the humoral response to the 12 serotypes it had in common with the initial pneumococcal vaccine. Seroprotective titers against 5 of the influenza strains from season 2015-2016 and 2016-2017 swung from 55.6% to 80.0% for Group A2 and 75% to 97% for Group B. At 8 weeks, 23.9% of Group A showed a positive response to the tetanus vaccine compared with a 54.5% positive response in Group B. At all time points, Group A showed a decrease in humoral response to the keyhole limpet hemocyanin compared with Group B.

 ”As expected, ocrelizumab attenuated the humoral response to the studied vaccines,” the study investigators concluded.

Disclosures: See the abstract for a full list of disclosures.

For more coverage of CMSC 2018, click here.

Reference

Stokmaier D, Winthrop K, Chognot C, et al. Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis. Presented at: 2018 CMSC Annual Meeting. May 30-June 2, 2018; Nashville, Tennessee. Abstract DX43.

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