MOC06
Timing Disease-Modifying Therapies with COVID-19 Vaccine in Multiple Sclerosis Patients: A Real-World Data
Scheduling of COVID-19 vaccine in multiple sclerosis (MS) patients on disease-modifying therapies (DMTs) according to the available guidelines is a challenging issue.
Objectives:
This study provides real-world data of vaccination status and time intervals among vaccine doses in this population to apply for practicing improvement.
Methods:
This is a cross-sectional study of 601 MS patients, inclusive of all subtypes, who were assessed during 2021. The data was obtained from the database of the FHMS clinic at Burnaby hospital. The first time interval, defined as TI1, was between the first and second dose, while TI2 was between the second and booster doses (BD). Patients were categorized into four groups according to the type of DMT, including "Induction DMTs" (Tysabri, Mavenclad, Lemtrada, Rituximab, Ocrevus, and Kesimpta), "Injectable DMTs" (Interferons, Copaxone/Glatect), "Oral DMTs" (Tecfidera, Aubagio, Fingolimod, Siponimod), and "No DMTs". We compared TIs, the proportion of fully vaccinated patients (FV), and patients who received BD among treatment groups.
Results:
For all patients, the means of age, TI1, and TI2 were 49.13 ± 12.67 years, 72.61 ± 29.93 days, and 136.02 ± 50.59 days, respectively. 80.3% of patients were FV and 51% of them received BD. Distribution of patients in treatment groups were: 157 (26.1%) in "Induction DMTs", 130 (21.6%) in "Oral DMTs", 66 (11%) in "injectable DMTs" and 248 (41.3%) in "no DMTs" groups. The TIs were significantly and positively correlated with age (p<0.001). There were no differences in TIs and FV patients among groups that received different types of DMTs. The number of patients who received BD in the "Induction DMTs" group was significantly lower than other DMT groups ("Oral DMTs" (p=0.04) and "Injectable DMTs" (p=0.003)). In “no DMTs” group, a lower number of patients received BD (p<0.001), and TI2 was longer than patients in other treatment groups.
Conclusions:
Results highlight that patients of older age were more likely to delay their vaccination doses. The majority of patients had the correct timing with respect to getting DMTs and their vaccines. However, patients on "Induction DMTs" have postponed BD, probably due to time and method of getting DMTs. Patients who received no DMTs have delayed BD likely because of the local policy for 6 months TI2 for the general population. The data provides real-world evidence on the complexity of vaccination schedules for a large number of MS patients on different treatments.