Varicella zoster immunity loss in multiple sclerosis patient treated with ocrelizumab

Varicella zoster immunity loss in multiple sclerosis patient treated with ocrelizumab

Ocrelizumab is a novel humanized anti-CD20 antibody used for treatment of relapsing remitting and primary progressive multiple sclerosis with evidence of inflammatory activity. Guidelines suggest assessing vaccination status and eventually vaccinate patients with multiple sclerosis before new diseas...

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Bibliographic Details
Published in:Clinical immunology (Orlando, Fla.) Vol. 223; p. 108554
Main Authors: Rapisarda, L., Valentino, P., Barone, S., Torti, C., La Gamba, V., Fortunato, F., Sammarra, I., Gambardella, A.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-02-2021
Subjects:
Immunity
Multiple sclerosis
Ocrelizumab
Varicella zoster
RRMS
Multiple sclerosis
PPMS
MS
IgG
Ocrelizumab
Immunity
Varicella zoster
IgM
LLN
VZV
WBC
IG
OCR
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Summary:Ocrelizumab is a novel humanized anti-CD20 antibody used for treatment of relapsing remitting and primary progressive multiple sclerosis with evidence of inflammatory activity. Guidelines suggest assessing vaccination status and eventually vaccinate patients with multiple sclerosis before new disease modifying therapy initiation. However, there are not any specific recommendations about vaccinal immunity reassessment after ocrelizumab injection. We describe the case of a patient who loss varicella zoster vaccinal immunity after the first ocrelizumab infusion. It is advisable to reassess vaccinal immunity to isolate non-immune patients and to adopt suitable preventive measures, including close contacts vaccination and avoidance of contacts with active infection. •Vaccination should be updated before any DMT.•Live-attenuated vaccines are contraindicated during immunosuppression and, of course, during anti-CD20 treatment.•Immunization decreases over age.•Cocooning strategy should be recommended in case of contraindication for updating vaccinations in negative patients.•Anti CD-20 treatment decreases vaccines efficacy.
Bibliography:ObjectType-Case Study-2
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ISSN:1521-6616
1521-7035
DOI:10.1016/j.clim.2020.108554