Abstract Details

Title SARS-CoV-2 Vaccine Immune Response on Anti-Complement Therapy, Eculizumab

Topic Autoimmune Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-012

Objective To investigate immune response against SARS-CoV-2 spike protein in patients treated with anti-complement therapy, Eculizumab.

Background Certain Immunomodulatory therapies used to treat autoimmune conditions attenuate immunoglobulin production following SARS CoV-2 vaccination, and may increase susceptibility to COVID-19 infections and/or COVID-19 severity. Here we studied immune response against SARS-CoV-2 vaccine in patients treated with Eculizumab, a disease modifying treatment used for multiple autoimmune conditions including Neuromyelitis Optica Spectrum Disorders (NMOSD).

Design/Methods We searched the Stanford Research Repository (STARR) database and identified 38 patients treated with eculizumab, who were tested for SARS-CoV-2-IgG and SARS-CoV-2 Interferon Gamma Release Assay (IGRA). 7/38 patients were on eculizumab at the time of vaccination against SARS-CoV-2 and testing for vaccine immunity.

Results Subjects’ mean age was 49.28±18.7 years (6 females and 1 male) with average duration of eculizumab at the time of first dose of vaccine of 12.7±11.6 months, and the interval between the second dose of vaccine and testing was 7.09±6.2 months. All patients had a positive antibody response to SARS-CoV-2 spike protein IgG (100%). Only 3 patients who had IGRA tested, of which 2 were positive for IGRA (66.66%). Two out of 7 patients (28.6%) had mild lymphopenia at the time of vaccination. Our results contrast with our previously reported cohort of multiple sclerosis patients on anti-CD20 therapy who had 71% (17/24) positive SARS-CoV-2 IGRA but negative for SARS-CoV-2 IgG. These findings are explained by different mechanisms of action for these two medications.

Conclusions Based on our findings, eculizumab preserves both B and T cell immunity against SARS-CoV-2 vaccine. The clinical correlation is to be determined.

Authors/Disclosures
Neda Sattarnezhad Oskouei, MD (Stanford Univesrity) PRESENTER	Dr. Sattarnezhad Oskouei has received research support from National Institutes of Health (NIH). Dr. Sattarnezhad Oskouei has received research support from National Institute of Allergy and Infectious Diseases (NIAID).
Julia Sumera (Stanford Neurology)	Miss Sumera has nothing to disclose.
Jamie C. McDonald, MD (Stanford University)	Dr. McDonald has nothing to disclose.
Esther H. Nie, PhD (Stanford Healthcare Center for Academic Medicine (CAM))	Dr. Nie has received personal compensation for serving as an employee of Kyverna Therapeutics. Dr. Nie has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medidata, Acorn AI. The institution of Dr. Nie has received research support from Roche/Genentech.
Anna J. Tomczak, MSc (Stanford)	Miss Tomczak has nothing to disclose.
Yamuna Joseph (Stanford University)	No disclosure on file
	No disclosure on file
Tara Tripathi Sarkar (Stanford University)	No disclosure on file
Lucas Kipp, MD	The institution of Dr. Kipp has received research support from Genentech.
Christopher Lock, MD, MBBS, PhD (Stanford University)	Dr. Lock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Lock has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Lock has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Turning Point Litigation. Dr. Lock has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Goodell, DeVries, Leech & Dann, LLP. Dr. Lock has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for McQuaide Blasko Attorneys at Law. Dr. Lock has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for BENNETT BIGELOW & LEEDOM P.S. .
Jeffrey E. Dunn, MD, FAAN (Stanford University Medical Center)	Dr. Dunn has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Dunn has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme. The institution of Dr. Dunn has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Progentec Diagnostics. Dr. Dunn has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna Therapeutics. Dr. Dunn has received intellectual property interests from a discovery or technology relating to health care.
May Han, MD (Stanford University)	Dr. Han has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Han has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arena Pharmaceuticals.

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