Immunoglobulin G immune response to SARS-CoV-2 vaccination in people living with multiple sclerosis within Multiple Sclerosis Partners Advancing Technology and Health Solutions

Abstract

Background: The impact of multiple sclerosis (MS) disease-modifying therapies (DMTs) on SARS-CoV-2 vaccination response is uncertain. Methods: Post-SARS-CoV-2 vaccination blood samples across multiple DMTs were tested for SARS-CoV-2 immunoglobulin G (IgG) response. Results: Three hundred twenty-two people with MS were included; 91.9% received an mRNA vaccine. Post-vaccination reactive IgG rates (IgG index > 1) were 40% for anti-CD20 (32/80 patients); 41% for sphingosine 1-phosphate receptor modulators (S1PRM, 16/39); and 100% for all other classes, including the no DMT group. Conclusion: Anti-CD20 therapies and S1PRMs reduce IgG response to SARS-CoV-2 vaccination; IgG response is preserved with other DMTs.

Two years of COVID-19 in the MS community: What have we learnt so far?

“…As MS is an immune-mediated disease and DMTs alter or suppress the immune system in different ways, many recent studies have focused on the immunological responses after SARS-CoV-2 infection or vaccination. Overall, most pwMS present an immunological response after SARS-CoV-2 infection (humoral response: 76.8%-83.4%; cellular response: 59.5%) [11][12][13] or vaccination (humoral response: 74.4%-86.8%; cellular response: 62%-84.4%) [14][15][16][17] regardless of their treatment. However, it is clear by now that anti-CD20 therapies and sphingosine-1-phosphate receptor modulator (SP1RM) therapies decrease these responses.…”

“…However, it is clear by now that anti-CD20 therapies and sphingosine-1-phosphate receptor modulator (SP1RM) therapies decrease these responses. 11,[15][16][17][18] Anti-CD20 therapies impair memory B-cell production, leading to a blunted humoral response. In the study of Sormani et al, an SARS-CoV-2 serological response, after COVID-19, was observed in only 44.6% of patients on anti-CD20 therapies compared with 78.7% of the rest of patients.…”

“…11 Similar seroconversion rates are seen after vaccination (40.0%-50.0%). 15,17,18 In these patients, seroconversion is highly predicted by B-cell count and time elapsed since last infusion. 14,17,18 Despite the reduction of seroconversion, it remains a robust T-cell response after both infection (66.7%) 13 and vaccination (86.4%-92%).…”

“…SP1RM therapies prevent lymphocytes from leaving the lymph nodes. These treatments present an underwhelming vaccination response in relation to both humoral (41-51.4) 15,17 and cellular responses (11.0%-14.0%). 16,17 However, immune responses after infection seem to be relatively preserved (66.7-80.0).…”

“…However, it is clear by now that anti-CD20 therapies and sphingosine-1-phosphate receptor modulator (SP1RM) therapies decrease these responses. 11,15–18…”