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Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies
| Content Provider | SAGE Publishing |
|---|---|
| Author | Achiron, Anat Mandel, Mathilda Dreyer-Alster, Sapir Harari, Gil Magalashvili, David Sonis, Polina Dolev, Mark Menascu, Shay Flechter, Shlomo Falb, Rina Gurevich, Michael |
| Copyright Year | 2021 |
| Abstract | Background and Aims:The National Multiple Sclerosis Society and other expert organizations recommended that all patients with multiple sclerosis (MS) should be vaccinated against COVID-19. However, the effect of disease-modifying therapies (DMTs) on the efficacy to mount an appropriate immune response is unknown. We aimed to characterize humoral immunity in mRNA-COVID-19 MS vaccinees treated with high-efficacy DMTs.Methods:We measured SARS-CoV-2 IgG response using anti-spike protein-based serology (EUROIMMUN) in 125 MS patients vaccinated with BNT162b2-COVID-19 vaccine 1 month after the second dose. Patients were either untreated or under treatment with fingolimod, cladribine, or ocrelizumab. A group of healthy subjects similarly vaccinated served as control. The percent of subjects that developed protective antibodies, the titer, and the time from the last dosing were evaluated.Results:Protective humoral immunity of 97.9%, 100%, 100%, 22.7%, and 3.8%, was observed in COVID-19 vaccinated healthy subjects (N = 47), untreated MS patients (N = 32), and MS patients treated with cladribine (N = 23), ocrelizumab (N = 44), and fingolimod (N = 26), respectively. SARS-CoV-2 IgG antibody titer was high in healthy subjects, untreated MS patients, and MS patients under cladribine treatment, within 29.5–55 days after the second vaccine dose. Only 22.7% of patients treated with ocrelizumab developed humoral IgG response irrespective to normal absolute lymphocyte count. Most fingolimod-treated MS patients had very low lymphocyte count and failed to develop SARS-COV-2 antibodies. Age, disease duration, and time from the last dosing did not affect humoral response to COVID-19 vaccination.Conclusions:Cladribine treatment does not impair humoral response to COVID-19 vaccination. We recommend postponing ocrelizumab treatment in MS patients willing to be vaccinated as a protective humoral response can be expected only in some. We do not recommend vaccinating MS patients treated with fingolimod as a protective humoral response is not expected. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/17562864211012835?download=true |
| ISSN | 17562864 |
| Volume Number | 14 |
| Journal | Therapeutic Advances in Neurological Disorders (TAN) |
| e-ISSN | 17562864 |
| DOI | 10.1177/17562864211012835 |
| Language | English |
| Publisher | Sage Publications UK |
| Publisher Date | 2021-04-22 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights Holder | © The Author(s), 2021 |
| Subject Keyword | COVID-19 multiple sclerosis SARS-COV-2 IgG humoral immune response mRNA vaccine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Neurology (clinical) Pharmacology |
