Main Takeaways
Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs) As a result, immune responses to COVID-19 vaccinations could be compromised .
ID: 1277216
Short Link: https://gregory-ms.com/articles/1277216/
Discovery Date: 18 March 2023, 23:10:16 UTC
Published Date: 2023-03-18 10:00:00
Source: PubMed
Link: https://pubmed.ncbi.nlm.nih.gov/36933032/?fc=20210216052009&ff=20230318191014&v=2.17.9.post6+86293ac
Manual Selection: none
Machine Learning Gaussian Naive Bayes Model: false
Abstract
J Neurol. 2023 Mar 18. doi: 10.1007/s00415-023-11575-8. Online ahead of print.
ABSTRACT
BACKGROUND: Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs). As a result, immune responses to COVID-19 vaccinations could be compromised. There are few data on cellular immune responses to the use of COVID-19 vaccine boosters in pwMS under a broad spectrum of DMTs.
METHODS: In this prospective study, we analysed cellular immune responses to SARS-CoV-2 mRNA booster vaccinations in 159 pwMS with DMT, including: ocrelizumab, rituximab, fingolimod, alemtuzumab, dimethyl fumarate, glatiramer acetate, teriflunomide, natalizumab and cladribine.
RESULTS: DMTs, and particularly fingolimod, interact with cellular responses to COVID-19 vaccination. One booster dose does not increase cellular immunity any more than two doses, except in the cases of natalizumab and cladribine. SARS-CoV-2 infection combined with two doses of vaccine resulted in a greater cellular immune response, but this was not observed after supplementary booster jabs. Ocrelizumab-treated pwMS who had previously received fingolimod did not develop cellular immunity, even after receiving a booster. The time after MS diagnosis and disability status negatively correlated with cellular immunity in ocrelizumab-treated pwMS in a booster dose cohort.
CONCLUSIONS: After two doses of SARS-CoV-2 vaccination, a high response yield was achieved, except in patients who had received fingolimod. The effects of fingolimod on cellular immunity persisted for more than 2 years after a change to ocrelizumab (which, in contrast, conserved cellular immunity). Our results confirmed the need to find alternative protective measures for fingolimod-treated people and to consider the possible failure to provide protection against SARS-CoV-2 when switching from fingolimod to ocrelizumab.
PMID:36933032 | DOI:10.1007/s00415-023-11575-8
Noun Phrases in Title
- A prospective study
- cellular immune response
- booster COVID-19 vaccination
- multiple sclerosis patients
- a broad spectrum
- disease-modifying therapies