Serological response to SARS-CoV-2 vaccination in multiple sclerosis patient in a real-life experience

ABSTRACT

Introduction: Vaccination against COVID-19 has been widely recommended for patients with multiple sclerosis (MS), although the effect of different disease-modifying treatments (DMTs) on said immunization is not well known. Some studies begin to point out a relationship between DMTs of greater efficacy with a lower rate of seroprotection. Objectives: To assess serological response to SARS-CoV-2 vaccination in MS patients receiving disease-modifying treatments (DMTs) in a real-life setting. Methods: Anti-spike protein-based serology was measured in 191 patients with MS and 6 patients with neuromyelitis optica spectrum disorder (NMOSD). Patients were either untreated or under treatment with different DMTs. A group of healthy subjects similarly vaccinated served as control. The percent of subjects that developed protective antibodies, the antibody-titer, and lymphocyte counts were evaluated. Results: Patients and controls were vaccinated with different available vaccines BNT162b2 (68.6%), mRNA-1273 (5.4%), ChAdOx1-S (20.7%) and Ad26COVS1 (4.3%). Protective serological response was observed in 100% of controls, NMOSD, untreated (n=19), Interferon-beta (n=17), Glatiramer-acetate (n=15), Cladribine (n=11), Dimethyl-fumarate (n=15), Teriflunomide (n=29) and Natalizumab (n=25) patients. 100% was also observed in Alemtuzumab (n=11) patients but none received treatment dose in last year. Serological response was observed in 42%, 44% and 0% of Fingolimod (n=12), Ocrelizumab (n=26) and Rituximab (n=6) patients respectively. Time from the last dosing was related to serological response in anti-CD-20 therapies;age, disease duration, disease phenotype, vaccine used, or lymphocyte counts did not affect humoral response to COVID-19 vaccination. Conclusions: Anti-CD20 therapies and Fingolimod seem to condition a lower humoral response to vaccines against SARS-CoV-2. Vaccination prior initiation of these DMTs medication administration would be recommendable whenever possible.