Abstract
Background: Few data are available so far on the antibody-mediated immune response to anti-SARS-Cov2 vaccination in people with multiple sclerosis (pwMS) treated with disease-modifying treatments (DMTs), therefore this issue was explored in a real-life cohort of pwMS.
Materials and methods: Retrospective monocentric study on anti-spike protein antibody response in pwMS who had received vaccination for Sars-Cov2. Adverse events following vaccination were also recorded.
Results: One hundred and twenty pwMS were included: 83 females (69%); median age at vaccination 42 years (range 21-73); 112/120 patients (93%) were receiving DMTs at vaccination. Anti-spike protein IgG antibodies were detectable in 102/120 (85%) cases overall, being the proportion lower in pwMS receiving anti-CD20 antibodies (14/31, 45%) compared to non-depletive treatments (77/78, 99%), p < 0.0001. Median anti-spike titre was lower in anti-CD20 antibodies and fingolimod-treated pwMS compared to those receiving other DMTs, and it correlated with anti-CD20 treatment duration (R – 0.93, p < 0.0001) and with age at vaccination in pwMS not receiving depletive treatments (R – 0.25, p = 0.028). Baseline CD19+ cell count (where available) was higher in the responder group than in non-responders, p < 0.0001. Two symptomatic COVID-19 infections were diagnosed over a median follow-up of 5 months (range 2-7); adverse events were aligned with the published literature.
Conclusion: Antibody response to anti-COVID-19 vaccines was detected in most of the pwMS analysed, but frequency of responders was reduced in those receiving CD20 depleting therapies compared to other DMTs-treated pwMS. Investigations on cell-mediated immune response are needed to assess whether a protective immune response is elicited also in non-antibody responders.
Keywords: Antibody response; CD20 deplething therapies; COVID-19 vaccines; Disease-modifying therapies; Multiple sclerosis.
【저자키워드】 Antibody Response, COVID-19 vaccines, Disease-modifying therapies, multiple sclerosis., CD20 deplething therapies, 【초록키워드】 COVID-19, Treatment, Vaccine, immune response, vaccination, therapy, multiple sclerosis, antibody, Antibody Response, adverse events, Protein, Cohort, COVID-19 vaccines, IgG antibody, COVID-19 infection, non-responders, symptomatic, adverse event, female, Patient, age, Follow-up, Responder, fingolimod, Anti-spike, anti-CD20, Anti-CD20 antibodies, CD20, Anti-CD20 antibody, investigation, Frequency, CD19, Adverse, median age, COVID-19 infections, protective immune response, titre, responders, anti-CD20 treatment, material, cell-mediated immune response, cell count, CD19+, Multiple, event, proportion, detectable, diagnosed, receiving, analysed, median, treated, correlated, elicited, depleting, recorded, was reduced, aligned, cell-mediated immune, 【제목키워드】 Treatment, vaccination, Effect,