Humoral efficacy of the third SARS-CoV-2 vaccine dose in Multiple Sclerosis subjects undergoing different disease-modifying therapies

Maniscalco, Giorgia Teresa; Liotti, Antonietta; Ferrara, Anne Lise; Prestipino, Elio; Salvatore, Simona; Battista, Maria Elena Di; Moreggia, Ornella; Cesare, Daniele Di Giulio; Vastano, Roberta; Belardo, Martina; Napolitano, Massimo; Ranieri, Angelo; Longo, Katia; Andreone, Vincenzo; Rosa, Veronica De

doi:10.1016/j.msard.2022.104371

Cited by 10 publications

(10 citation statements)

References 25 publications

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“…While immune responses to primary vaccination are relatively well studied, less is known about the durability of these vaccination responses. Similar to the kinetics of antibodies in the general population, several studies showed a decrease in SARS-CoV-2-specific humoral responses during the six months after initial vaccination in anti-CD20-treated people with MS (pwMS) [ 17 , 18 , 19 , 20 , 21 , 22 ], whereas other studies reported no significant reduction in antibody titers over time, possibly attributable to initially low titers [ 3 , 23 , 24 , 25 , 26 ]. As for virus-specific T-cell responses, two studies reported a decline thereof in the months following primary vaccination [ 16 , 18 ].…”

Section: Introductionmentioning

confidence: 87%

Long-Term Immune Response Profiles to SARS-CoV-2 Vaccination and Infection in People with Multiple Sclerosis on Anti-CD20 Therapy

Woopen,

Dunsche,

Al Rahbani

et al. 2023

Vaccines

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Our objective was to analyze longitudinal cellular and humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in people with multiple sclerosis (pwMS) on B-cell depleting treatment (BCDT) compared to pwMS without immunotherapy. We further evaluated the impact of COVID-19 infection and vaccination timing. PwMS (n = 439) on BCDT (ocrelizumab, rituximab, ofatumumab) or without immunotherapy were recruited for this prospective cohort study between June 2021 and June 2022. SARS-CoV-2 spike-specific antibodies and interferon-γ release of CD4 and CD8 T-cells upon stimulation with spike protein peptide pools were analyzed at different timepoints (after primary vaccination, 3 and 6 months after primary vaccination, after booster vaccination, 3 months after booster). Humoral response to SARS-CoV-2 was consistently lower whereas T-cell response was higher in patients with BCDT compared to controls. Cellular and humoral responses decreased over time after primary vaccination and increased again upon booster vaccination, with significantly higher antibody titers after booster than after primary vaccination in both untreated and B-cell-depleted pwMS. COVID-19 infection further led to a significant increase in SARS-CoV-2-specific responses. Despite attenuated B-cell responses, a third vaccination for patients with BCDT seems recommendable, since at least partial protection can be expected from the strong T-cell response. Moreover, our data show that an assessment of T-cell responses may be helpful in B-cell-depleted patients to evaluate the efficacy of SARS-CoV-2 vaccination.

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Section: Introductionmentioning

confidence: 87%

Long-Term Immune Response Profiles to SARS-CoV-2 Vaccination and Infection in People with Multiple Sclerosis on Anti-CD20 Therapy

Woopen,

Dunsche,

Al Rahbani

et al. 2023

Vaccines

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show abstract

“…50 Median IgG titers in 11 pwMS treated with DMF were comparable to those observed in healthy controls, 21 days after a third dose of BNT162b2. 51 However, a study assessing IFN-γ response to severe acute respiratory syndrome-coronavirus-2 spike protein antigens as a marker for the cellular response found that responses were not significantly different in pwMS on DMF following a booster vaccine, and responder rates were similar after two or three doses (68.4% and 71.4%, respectively). 52 Meta-analyses of COVID-19 vaccine response in pwMS found no significant effect of DMF on the serological response or seroconversion rates post-vaccination compared with untreated patients.…”

Section: Mechanisms Of Action and Immunological Effects Of Fumarates ...mentioning

confidence: 99%

“…20 Few studies have assessed the responses in pwMS on DMF following booster doses of COVID-19 vaccines, but outcomes reported so far for humoral responses indicate IgG titers and seroconversion rates comparable to those in healthy controls. 50,51 In an observational study, all 15 pwMS on DMF who received booster doses of BNT162b2 or Sinovac vaccines were seropositive at least 2 weeks afterward. 50 Median IgG titers in 11 pwMS treated with DMF were comparable to those observed in healthy controls, 21 days after a third dose of BNT162b2.…”

Section: Mechanisms Of Action and Immunological Effects Of Fumarates ...mentioning

confidence: 99%

Vaccine response in people with multiple sclerosis treated with fumarates

Tremblay,

Vukusic,

Shanmugasundaram

et al. 2023

Multiple Sclerosis Journal - Experimental, Translational and Cl

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People with multiple sclerosis (pwMS) have an increased risk of infection. As disease-modifying therapies (DMTs) and other treatments may interact with the immune system, there may be concerns about vaccine efficacy and safety. Therefore, it is important to evaluate possible interactions between DMTs and vaccines. The fumarates, dimethyl fumarate, diroximel fumarate, and monomethyl fumarate, are approved for the treatment of relapsing multiple sclerosis. This review assesses the evidence on vaccine response in pwMS treated with fumarates, with a particular focus on COVID-19 vaccines. Treatment with fumarates does not appear to result in blunting of humoral responses to vaccination; for COVID-19 vaccines, particularly RNA-based vaccines, evidence indicates antibody responses similar to those of healthy recipients. While data on the effect of fumarates on T-cell responses are limited, they do not indicate any significant blunting. COVID-19 vaccines impart a similar degree of protection against severe COVID-19 infection for pwMS on fumarates as in the general population. Adverse reactions following vaccination are generally consistent with those observed in the wider population; no additional safety signals have emerged in those on fumarates. Additionally, no increase in relapse has been observed in pwMS following vaccination. In pwMS receiving fumarates, vaccination is generally safe and elicits protective immune responses.

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“…Immune system dysregulation in PLWMS treated with immunosuppressive agents can result in vaccine hyporesponsiveness ( Otero-Romero et al, 2021 ). A growing body of literature showed a diminished humoral immune response following COVID-19 vaccine among MS patients receiving anti-CD20 agents and fingolimod ( Apostolidis et al, 2021 ; Capuano et al, 2022 ; Etemadifar et al, 2022 ; Holroyd et al, 2022 ; Maniscalco et al, 2022 ; Ozakbas et al, 2022 ; Satyanarayan et al, 2022 ; Tallantyre et al, 2022 ; Yeo et al, 2022 ). This finding was also observed after the booster dose of the vaccine ( Maniscalco et al, 2022 ; Wallach et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of BBIBP-CorV vaccine in preventing SARS-CoV2 infection and severe outcomes in people living with multiple sclerosis: A population-based study

Barzegar

Manteghinejad²,

Afshari-Safavi³

et al. 2023

Multiple Sclerosis and Related Disorders

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Humoral efficacy of the third SARS-CoV-2 vaccine dose in Multiple Sclerosis subjects undergoing different disease-modifying therapies

Cited by 10 publications

References 25 publications

Long-Term Immune Response Profiles to SARS-CoV-2 Vaccination and Infection in People with Multiple Sclerosis on Anti-CD20 Therapy

Long-Term Immune Response Profiles to SARS-CoV-2 Vaccination and Infection in People with Multiple Sclerosis on Anti-CD20 Therapy

Vaccine response in people with multiple sclerosis treated with fumarates

Effectiveness of BBIBP-CorV vaccine in preventing SARS-CoV2 infection and severe outcomes in people living with multiple sclerosis: A population-based study

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