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Humoral and Cellular Responses to SARS-CoV-2 Vaccines in MS Patients on Ocrelizumab and Other Disease-modifying Therapies: A Prospective Study From NYU Multiple Sclerosis Care Center
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925324
ABSTRACT

Objective:

To compare humoral and cellular responses to COVID-19 vaccines in 400 consecutive MS patients who were on Ocrelizumab ('OCR') and other disease-modifying therapies ('nonOCR') at the time of vaccination.

Background:

Peripheral B-cell depletion with anti-CD20 therapies, attenuates humoral responses to vaccines, but less is known about cellular responses. Design/

Methods:

Consecutive MS patients from NYU MS Care Center were invited to participate if they completed COVID-19 vaccination ≥6 weeks previously. Immune testing included anti-spike RBD antibody (Elecsys Anti-SARS-CoV-2) (Roche Diagnostics);multiepitope bead-based immunoassays (MBI) of antibody-responses to SARS-COV-2 spike proteins (threshold of 'positivity'was chosen as 2 SD below non-OCR mean);T-cell responses to SARSCoV-2 Spike protein using IFNγ enzyme-linked immune-absorbent spot (Invitrogen) and TruCulture (Myriad RBM) assays;high dimensional immunophenotyping;live virus immunofluorescence-based microneutralization assay.

Results:

Antibody and T cell data was available on 145/355 patients enrolled to date (mean age 40.0 years;75% female;48% non-white;39% on OCR;12% with prior COVID-19 infection;vaccines 58% Pfizer/BioNTech, 36% Moderna and 6% Johnson&Johnson;median vaccine-tosample time 93 (+/-32) days). In OCR, Elecsys Anti-SARS-CoV-2 Ab titers were detected in 30/63 (48%;mean antibody titer in log scale 1.63) and in non-OCR - in 78/81 (96%, mean Ab titer in log scale 2.83;p<0.0001). In OCR, antibody response by MBI were detected in 41/57 (72%, mean level in log scale 3.09) and in non OCR - in 68/72 (94%, mean level in log scale 4.08;p<0.001). Neutralizing antibodies were detected in 10/42 (38%) of OCR and 24/43 (56%) of non-OCR (p=0.1). T-cell activation based on induced IFNg secretion (TruCulture) was observed in 50/64 (78%) OCR and 43/81 (53%) non-OCR (p=0.002).

Conclusions:

Preliminary results suggest robust vaccine-specific T-cell immune response to SARS-CoV2 vaccines in B-cell depleted patients, but markedly attenuated antibody responses. Final results of pre-planned multivariable analyses stratified by DMT class and high-dimensional immunophenotyping will be presented.
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Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Language: English Journal: Neurology Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Language: English Journal: Neurology Year: 2022 Document Type: Article