Humoral immune response to SARS-CoV-2 third vaccination in patients with multiple sclerosis and healthy controls: A prospective multicenter study

BACKGROUND: Third vaccination against SARS-CoV-2 is recommended for patients with multiple sclerosis (pwMS), usually six months after the last vaccination. METHODS: In this prospective multicenter study on 292 pwMS and 46 healthy controls (HC), who had all received two vaccinations prior to study en...

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Detalles Bibliográficos
Autores principales: Krajnc, Nik, Hegen, Harald, Traxler, Gerhard, Leutmezer, Fritz, Di Pauli, Franziska, Kornek, Barbara, Rommer, Paulus, Zulehner, Gudrun, Riedl, Katharina, Dürauer, Sophie, Bauer, Angelika, Kratzwald, Sarah, Klotz, Sigrid, Winklehner, Michael, Deisenhammer, Florian, Guger, Michael, Höftberger, Romana, Berger, Thomas, Bsteh, Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Author(s). Published by Elsevier B.V. 2022
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9250418/
https://www.ncbi.nlm.nih.gov/pubmed/35797803
http://dx.doi.org/10.1016/j.msard.2022.104009
Descripción
Sumario:BACKGROUND: Third vaccination against SARS-CoV-2 is recommended for patients with multiple sclerosis (pwMS), usually six months after the last vaccination. 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: 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 ([Formula: see text] = –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: 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

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