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MS patients at risk of hampered immune response after vaccination

Presented By
Prof. Maria Pia Sormani, University of Genoa, Italy
Conference
ECTRIMS 2021

MS patients treated with ocrelizumab, rituximab, or fingolimod showed a reduced immune response after SARS-CoV-2 mRNA vaccination. In addition, higher SARS-CoV-2 antibody levels were observed in MS patients who received the Moderna vaccine compared with the Pfizer/BioNTech vaccine. Although 4 weeks after the second dose the Moderna vaccine generated higher antibody levels in MS patients receiving anti-CD20 therapies or fingolimod [1,2], it is unclear if this is of practical significance in anti-SARS-CoV-2 protective immunity.

Disease-modifying therapies (DMTs) in MS patients are associated with a decreased immune response to antigens. A post-SARS-CoV-2 vaccination serological assessment was performed to examine the antibody response in MS patients treated with DMTs as compared with untreated patients. The current analysis of this prospective, multicentre cohort study assessed 1,339 MS patients (treated with a DMT, n=1,166; untreated, n=173) who received 2 doses of SARS-CoV-2 mRNA vaccines (Pfizer/BioNTech or Moderna). Blood samples were collected before the 1st dose, and 4 weeks after the 2nd dose. A centralised, blinded serological assessment was performed at each timepoint. Prof. Maria Pia Sormani (University of Genoa, Italy) shared the results.

Multivariate analysis revealed decreased antibody levels in patients treated with ocrelizumab (231-fold decrease, P<0.001), rituximab (20-fold decrease, P<0.001), or fingolimod (32-fold decrease, P<0.001) compared with untreated patients. Notably, patients on anti-CD20 (ocrelizumab/rituximab) therapies developed higher antibody levels when the time to the last administered infusion was longer. Patients who received the Moderna vaccine developed significantly higher antibody levels (2.9-fold) compared with those who received Pfizer/BioNTech (P<0.001). A booster vaccine may therefore be beneficial for patients with low antibody levels.

    1. Sormani MP. Effect of SARS-CoV-2 mRNA vaccination in multiple sclerosis patients treated with disease modifying therapies. OP099, ECTRIMS 2021 Virtual Congress, 13–15 October.
    2. Sormani MP, et al. EBioMedicine. 2021;72:103581.

 

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