Humoral immune response to SARS-CoV-2 third vaccination in patients with multiple sclerosis and healthy controls: A prospective multicenter study.
Disease-modifying therapy
Multiple sclerosis
SARS-CoV-2
Third
Vaccination
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
15
05
2022
revised:
22
06
2022
accepted:
01
07
2022
pubmed:
8
7
2022
medline:
8
9
2022
entrez:
7
7
2022
Statut:
ppublish
Résumé
Third vaccination against SARS-CoV-2 is recommended for patients with multiple sclerosis (pwMS), usually six months after the last vaccination. In this prospective multicenter study on 292 pwMS and 46 healthy controls (HC), who had all received two vaccinations prior to study enrollment, SARS-CoV-2 IgG response was measured in the month before and 2-4 months after third vaccination. PwMS were categorized as follows: untreated (N-DMT, n = 32), receiving disease-modifying therapy (DMT) with expected humoral response (er-DMT: interferon-beta preparations, glatiramer acetate, dimethyl fumarate, teriflunomide, natalizumab, cladribine, alemtuzumab; n = 120) or no expected humoral response (nr-DMT: S1PMs, CD20mAb; n = 140). PwMS on nr-DMT had significantly lower median antibody levels before (12.1 U/ml [0.4-2500]) and after third vaccination (305 U/ml [0.4-2500]) in comparison to other groups (p<0.001). We did not find differences in antibody levels after homologous (n = 281; 2500 [0.4-2500]) and heterologous (n = 57; 2500 [0.4-2500]) vaccination regime regardless of the DMT group. The DMT group (β= -0.60; 95% CI -1195.73, -799.10; p<0.001) was associated with antibody levels after third vaccination, while time to revaccination (6 months [1-13]) was not. After third vaccination, seropositivity was reached in 75.8% and 82.2% of pwMS on anti-CD20 mAbs and S1PMs, respectively. Complete B-cell depletion significantly decreased the probability of seroconversion even after the third vaccination (OR 0.14; p = 0.021), whereas time interval to last DMT intake and time to revaccination did not. Twenty-two patients reported a SARS-CoV-2 infection (3 N-DMT, 9 er-DMT, 10 nr-DMT), one being asymptomatic and the rest having a mild course. Humoral response to SARS-CoV-2 third vaccination in pwMS is excellent. While reduced by S1PMs and CD20mAb, protective response is still expected in the majority of patients.
Sections du résumé
BACKGROUND
BACKGROUND
Third vaccination against SARS-CoV-2 is recommended for patients with multiple sclerosis (pwMS), usually six months after the last vaccination.
METHODS
METHODS
In this prospective multicenter study on 292 pwMS and 46 healthy controls (HC), who had all received two vaccinations prior to study enrollment, SARS-CoV-2 IgG response was measured in the month before and 2-4 months after third vaccination. PwMS were categorized as follows: untreated (N-DMT, n = 32), receiving disease-modifying therapy (DMT) with expected humoral response (er-DMT: interferon-beta preparations, glatiramer acetate, dimethyl fumarate, teriflunomide, natalizumab, cladribine, alemtuzumab; n = 120) or no expected humoral response (nr-DMT: S1PMs, CD20mAb; n = 140).
RESULTS
RESULTS
PwMS on nr-DMT had significantly lower median antibody levels before (12.1 U/ml [0.4-2500]) and after third vaccination (305 U/ml [0.4-2500]) in comparison to other groups (p<0.001). We did not find differences in antibody levels after homologous (n = 281; 2500 [0.4-2500]) and heterologous (n = 57; 2500 [0.4-2500]) vaccination regime regardless of the DMT group. The DMT group (β= -0.60; 95% CI -1195.73, -799.10; p<0.001) was associated with antibody levels after third vaccination, while time to revaccination (6 months [1-13]) was not. After third vaccination, seropositivity was reached in 75.8% and 82.2% of pwMS on anti-CD20 mAbs and S1PMs, respectively. Complete B-cell depletion significantly decreased the probability of seroconversion even after the third vaccination (OR 0.14; p = 0.021), whereas time interval to last DMT intake and time to revaccination did not. Twenty-two patients reported a SARS-CoV-2 infection (3 N-DMT, 9 er-DMT, 10 nr-DMT), one being asymptomatic and the rest having a mild course.
CONCLUSION
CONCLUSIONS
Humoral response to SARS-CoV-2 third vaccination in pwMS is excellent. While reduced by S1PMs and CD20mAb, protective response is still expected in the majority of patients.
Identifiants
pubmed: 35797803
pii: S2211-0348(22)00518-1
doi: 10.1016/j.msard.2022.104009
pmc: PMC9250418
pii:
doi:
Substances chimiques
Antibodies, Viral
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
104009Subventions
Organisme : Austrian Science Fund FWF
ID : DOC 33
Pays : Austria
Informations de copyright
Copyright © 2022. Published by Elsevier B.V.
Références
Emerg Microbes Infect. 2021 Dec;10(1):629-637
pubmed: 33691606
Ther Adv Neurol Disord. 2021 Apr 22;14:17562864211012835
pubmed: 34035836
Ann Neurol. 2022 Mar;91(3):342-352
pubmed: 35067959
Mult Scler Relat Disord. 2022 Aug;64:103937
pubmed: 35700625
Lancet Neurol. 2018 Feb;17(2):162-173
pubmed: 29275977
Ann Rheum Dis. 2022 May;81(5):687-694
pubmed: 35027397
Front Immunol. 2022 Apr 01;13:868915
pubmed: 35432335
J Clin Microbiol. 2021 Mar 19;59(4):
pubmed: 33483360
Eur J Neurol. 2022 May;29(5):1538-1544
pubmed: 35102646
EBioMedicine. 2021 Oct;72:103581
pubmed: 34563483
Lancet. 2021 Sep 4;398(10303):856-869
pubmed: 34370971
EBioMedicine. 2022 Jun;80:104042
pubmed: 35526306
Nature. 2021 Apr;592(7855):616-622
pubmed: 33567448
Eur J Neurol. 2022 Jul 5;:
pubmed: 35791496
Mult Scler Relat Disord. 2022 May;61:103776
pubmed: 35364386
Neurology. 2021 Nov 9;97(19):e1870-e1885
pubmed: 34610987
J Neurol Sci. 2022 Mar 15;434:120155
pubmed: 35091386