Rabies vaccination and multiple sclerosis relapse: A retrospective cohort study

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Article

Reference

Rabies vaccination and multiple sclerosis relapse: A retrospective cohort study

CSAKI HUTTNER, Angela, et al.

Abstract

No studies assessing rabies vaccine (RV) tolerability in persons with multiple sclerosis (MS) have been conducted. Given the lack of safety data, RV is recommended essentially only for post-exposure prophylaxis, which is difficult to administer effectively in many rabies-endemic countries. We sought to determine whether RV administration as pre-exposure prophylaxis was associated with MS relapse.

CSAKI HUTTNER, Angela, et al . Rabies vaccination and multiple sclerosis relapse: A retrospective cohort study. Multiple Sclerosis and Related Disorders , 2021, vol. 51, p.

102906

DOI : 10.1016/j.msard.2021.102906 PMID : 33827005

Available at:

http://archive-ouverte.unige.ch/unige:153686

Disclaimer: layout of this document may differ from the published version.

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Online supplement to:

Rabies vaccination and multiple sclerosis relapse: a retrospective cohort study

Running head: Rabies vaccine and MS

Angela Huttner MD^a,b*, Agustina M. Lascano MD^c*, Serge Roth MD^c, Jean-Marc Schwob MD^d, Gilles Eperon MD^d, Claire-Anne Siegrist MD^a,e, Patrice H. Lalive MD^c,e,f**

aCenter for Vaccinology, University of Geneva, Geneva, Switzerland

bDivision of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland

cDepartment of Neurosciences, Division of Neurology, Unit of Neuroimmunology and Neuromuscular Diseases, Geneva University Hospitals, Geneva, Switzerland

dDivision of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland

eDepartment of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland

fDivision of Laboratory Medicine, Department of Diagnostic, Geneva University Hospitals, Geneva,

Switzerland

*Equal contribution

**Corresponding author:

Division of Neurology Geneva University Hospitals Rue Gabrielle-Perret-Gentil 4 1205 Geneva, Switzerland Tel. +41 22 3728318 Fax: +41 22 3728332 patrice.lalive@hcuge.ch

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2 Table S1. New brain and/or spinal cord lesions found on T1-weighted, gadolinium-enhanced or T2- weighted magnetic resonance imaging during the three study periods.

Pre-exposure period

Exposure-risk period

Post-risk period

Patients undergoing MRI, n* 51 22 46

Patients with new MRI lesions**, n (%) - Patients with new T1-Gad+ lesions - Patients with new T2 lesions only^§

37 (73) 25 (68) 12 (32)

8 (36) 4 (50) 4 (50)

9 (20) 4 (44) 5 (56) - Patients with asymptomatic lesions, n (%) 13 (35) 5 (63) 7 (78)

*Some patients underwent MRI in both the exposure-risk period and the post-risk period.

**Lesion(s) not present on any MRI before the MRI during the corresponding study period, and found on T2 and/or T1Gad+ MRI sequences.

§Without gadolinium enhancement on corresponding T1-weighted sequences.

Table S2. Univariate analyses of potential risk factors for relapse (n=3) in the exposure-risk period versus no relapse (n=52).

Characteristic Odds ratio 95% CI

Female sex 0.89 0.08 – 10.53

Over 40 years old 0.63 0.05 – 7.39

Receiving DMT at time of vaccination 0.37 0.03 – 4.30 Relapse in the year before vaccination 3.47 0.30 – 40.90 DMT: disease-modifying therapy

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3 Figure S1. Study timeline, with predefined pre-exposure, exposure, and post-risk periods.