Abstract
BACKGROUND AND OBJECTIVES: There are concerns on the safety of SARS-CoV-2 vaccination in patients with a history of Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). The aim of this study was to determine the risk of recurrence of GBS and exacerbations of CIDP or MMN after SARS-CoV-2 vaccination. METHODS: We conducted a prospective, multicenter cohort study from January 2021 to August 2021. Patients known in 1 of 3 Dutch University Medical Centers with research focus on immune-mediated neuropathy and members of the Dutch Patient Association for Neuromuscular Diseases were invited to participate if they were 18 years or older and diagnosed with GBS, CIDP, or MMN. Participants completed a series of questionnaires at 4 different time points: study baseline (1), within 48 hours before any SARS-CoV-2 vaccination (2 and 3, if applicable), and 6 weeks after their last vaccination (4). Participants unwilling to get vaccinated completed the last questionnaire (4) 4 months after study baseline. We assessed recurrences of GBS, any worsening of CIDP or MMN-related symptoms, treatment alterations, and hospitalization. RESULTS: Of 1,152 individuals to whom we sent the questionnaires, 674 (59%) signed informed consent. We excluded 153 individuals, most often because they had already received a SARS-CoV-2 vaccination or had had the infection (84%) before study baseline. Of 521 participants included in analyses, 403 (81%) completed the last questionnaire (time point 4). None of 162 participants with a history of GBS had a recurrence after vaccination. Of 188 participants with CIDP, 10 participants (5%) reported a worsening of symptoms within 6 weeks after vaccination. In 5 (3%) of these patients, maintenance treatment was modified. Two of 53 participants with MMN (4%) reported a worsening of symptoms, and treatment modification was reported by 1 participant. DISCUSSION: We found no increased risk of GBS recurrence and a low to negligible risk of worsening of CIDP or MMN-related symptoms after SARS-CoV-2 vaccination. Based on our data, SARS-CoV-2 vaccination in patients with these immune-mediated neuropathies seems to be safe.
| Original language | English |
|---|---|
| Pages (from-to) | e182-e191 |
| Number of pages | 24 |
| Journal | Neurology |
| Volume | 100 |
| Issue number | 2 |
| Early online date | 20 Sept 2022 |
| DOIs | |
| Publication status | Published - 10 Jan 2023 |
Bibliographical note
Funding Information:A.E. Baars reports no disclosures; Dr K. Kuitwaard received a research grant from Takeda and a consultancy fee from Takeda paid to the institution outside the submitted work. She received a speakers fee from Grifols paid to the institution outside the submitted work; L.C. de Koning reports no disclosures; L.W.G. Luijten reports no disclosures; W.M. Kok reports no disclosures; Dr F. Eftimov report grants from ZonMw (Dutch governmental agency) to study vaccination responses in patients with autoimmune diseases. Outside of the submitted work, as principal investigator of INCbase, he also reports investigator-initiated grants from Kedrion, Terumo BCT, CSL-Behring, Grifols and Takeda Pharmaceutical Company, and grants from ZonMw and Prinses Beatrix Spierfonds (a Dutch charity) for studies in CIDP. In addition, his institution has received fees from UCB Pharma, CSL Behring, Grifols, and Takeda for advisory board membership and/or lectures. All grants and fees were paid to his institution. He is a member of the Cochrane Neuromuscular Editorial Board; Dr L. Wieske received research grants from Grifols (2019) and the GBS/CIDP Foundation (2020) for the study of disease activity biomarkers in CIDP; Dr H.S. Goedee received research grants from Prinses Beatrix Spierfonds and travel grant/speaker fee from Shire/Takeda; Dr W.L. van der Pol has provided ad hoc consultancy services (scientific advisory board) to Biogen, Roche, Novartis Gene Therapies, Avexis, and Takeda and has obtained grants from Vriendenloterij, Spieren voor Spieren, and Prinses Beatrix Fonds; P.H. Blomkwist-Markens reports no disclosures; A.M.C. Horemans reports no disclosures; Dr B.C. Jacobs received research grants for work outside the current study from Baxalta, Grifols, CSL-Behring, Annexon, Hansa Biopharma, Roche, Prinses Beatrix Spierfonds, GBS-CIDP Foundation International, and Horizon 2020, and consultancy fees from Roche for activities outside the current study. All grants and fees were paid to his institution. He is the chair of the Steering Committee of International GBS Outcome Study (IGOS); Dr P.A. van Doorn received research grants from Prinses Beatrix Spierfonds, The Netherlands Organisation for Health Research and Development (ZonMW), Sanquin Blood supply, Takeda, and Grifols. He is a member of Scientific Advisory Committee/Steering Committee Trials for Annexon, Argenx, Hansa, Octapharma, Sanofi, and Roche. All grants and fees were paid to his institution. Go to Neurology.org/N for full disclosures.
Funding Information:
This study was supported by Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Funding Information:
This study was supported by ErasmusMCUniversity Medical Center, Rotterdam, the Netherlands.
Publisher Copyright:
© American Academy of Neurology.
