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Rituximab and COVID-19 Vaccine Response in Autoimmune Diseases
Rituximab is being prescribed for some Lambert-Eaton patients ‘off-label’ just like it is for other autoimmune disorders like multiple sclerosis. We’re well along with getting COVID-19 vaccinations, most of us get one or more additional boosters. The lingering question is: How effective are the vaccine shots when given to LEMS patients on Rituximab?
Rituximab is an immunotherapy treatment. Here’s a fact sheet about it from the Mayo Clinic, HERE.
Because the LEMS patient population is so small, we aren’t going to get big studies on the question postulated above. But, there has been one done for multiple sclerosis patients on Rituximab. It should be an interesting read for those LEMS patients on the treatment. I think it is illuminating and attempts to get at the answer of the COVID-19 vaccine effectiveness when on an immunosuppressant.
You can read the article, “With Rituximab, B-cell Counts Predict COVID-19 Vaccine Response”, HERE, from the Multiple Sclerosis News Today website.
If you’re on Rituximab infusions, how have you handled getting your vaccinations? We’d like to hear from you!
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4 Replies
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How timely! I just finished a 4 week protocol of Rituxan infusions. I have lymphoma in addition to LEMS, and this is the 5th round of Rituxan I have had since 2004. I may have previously mentioned that in 2020 I had a round of Rituxan, since LEMS could be a precursor to Small Cell Lung Cancer. I have since had all 4 Covid injections. My oncologist was curious about this very question. What effect does the Covid vaccine have on Rituxan and vice versa. My doctor ordered lab work to determine the level of my Covid antibodies. The result was “equivocal” which means there were not enough antibodies to determine a reading. It is undetermined whether this is because of LEMS or possibly Rituxan. So the doctor ordered a shot of Evusheld, which is supposed to boost antibody production. I have not had a repeat blood test yet, but I have an appointment with my primary doctor the beginning of July and will have the test repeated at that time.
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To me this is very exciting that your doctor is curious enough to run these antibodies tests. Please keep us informed as you gain more knowledge from them!
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Here is an update regarding my Covid antibodies. When I first had the SARS lab work, my value was .82, which was too low to categorize. After the Evusheld shot that I had about a month ago, my value is 571. That is categorized as “positive”. So the shot did what it was supposed to do. My doctor said I would probably need to repeat the lab work and injection in about 6 months. The pharmacy at the hospital (Northwestern Memorial in Chicago) investigated if there were any contraindications between LEMS, Firdapse, Covid vaccines, and Rituxan and did not find anything. In my non-medical opinion, I think that since LEMS is basically antibodies not acting like they are supposed to (the little devils!) that everyone should ask their doctor to do the lab work to see if they have Covid antibodies. I had 4 vaccine injections and my Covid antibodies were still almost non-existent. Much better now. I hope this information is valuable.
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I’ve read a good bit about the Evusheld shot and it’s effectiveness. This is really good information. Those on Rituxan and other immune suppressors should perhaps visit with their medical team about testing and the shot.
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