MS Drug Ocrevus May Diminish Vaccine Efficacy

According to a new study focused on multiple sclerosis (MS), a new medication may be reducing the efficacy of certain vaccines.

Researchers from Penn Medicine looked at patients who received Ocrevus and compared responses to tetanus, the seasonal flu, and pneumococcus vaccinations.

This study found that these patients mounted a positive response to the vaccines across groups, but the levels of immune responses conferred by the shots were lower across the board in patients treated with Ocrevus.

As an example, there was a positive response to the tetanus vaccine at 8 weeks in approximately 24 percent of those treated with Ocrevus, versus almost 55 percent of those who were not treated with Ocrevus. 

“This study shows that while people with MS treated with Ocrevus can still mount vaccine responses, it’s not nearly as strong as prior to treatment,” said Penn Medicine neurologist Amit Bar-Or, MD, FRCPC, chief of the Multiple Sclerosis division and director for the Center for Neuroinflammation and Experimental Therapeutics, and senior study author.

“While antibody responses were reduced in the ocrelizumab treated patients, they still responded to a certain level.”

"This is valuable information in terms of seasonal vaccines such as the flu – it appears safe for patients taking ocrelizumab to get vaccinated and vaccination is likely to provide them with at least some protection from such infections,” said Dr. Bar-Or.

During March 2017, the U.S. Food and Drug Administration (FDA) approved Ocrevus (ocrelizumab) as the first treatment for both relapsing (RMS) and progressive forms of multiple sclerosis (MS).

Ocrelizumab works by targeting and eliminating cells that have the CD20 molecule on their surface, which include a broad range of B cells of the immune system.

Recently, Genentech announced that patients who received OCREVUS as an early treatment option continuously experienced less disease progression than those who began treatment at a later time point. OCREVUS is now approved in over 55 countries across North America, South America, the Middle East, Eastern Europe, as well as in Australia, Switzerland and the European Union.

OPERA I and OPERA II are Phase III, randomized, double-blind, double-dummy, global multi-center studies evaluating the efficacy and safety of OCREVUS (600 mg administered by intravenous infusion every six months) compared with interferon beta-1a (44 mcg administered by subcutaneous injection three times per week) in 1,656 people with relapsing forms of MS.

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MS is a genetic disease that afflicts approximately 400,000 Americans with an estimated 10,000 new cases every year.

MS can cause many symptoms, including blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more.

More than two to three times as many women as men develop MS and this gender difference has been increasing over the past 50 years.

MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is most common in Caucasians of northern European ancestry.

Overall, findings of this study confirm the current prescribing recommendations for ocrelizumab – namely that patients should follow standard guidelines for receiving vaccines prior to treatment.

Which means, if MS patients require vaccinations, they should ideally get them 6 weeks prior to beginning treatment with Ocrelizumab.

Dr. Bar-Or added, “Research like this allows us to learn more both about the mechanisms underlying MS activity and injury, as well as the biology of MS treatments, which in turn will help us better individualize treatments for specific patients.”

This study presented by Bar-Or is sponsored by F. Hoffmann-La Roche Ltd, the holding company for Genentech. Bar-Or has participated as a speaker in meetings sponsored by and received consulting fees and/or grant support from Genentech/Roche, Medimmune, and Novartis.

The AAN abstract is available online.