Longitudinal T-Cell Responses After a Third SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis on Ocrelizumab or Fingolimod
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Abstract
Objectives To evaluate whether a third vaccination shows an added effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) T-cell responses in patients with multiple sclerosis treated with ocrelizumab or fingolimod.
Methods This is a substudy of a prospective multicenter study on SARS-CoV-2 vaccination in patients with immune-mediated diseases. Patients with MS treated with ocrelizumab, fingolimod, and no disease-modifying therapies and healthy controls were included. The number of interferon (IFN)-γ secreting SARS-CoV-2–specific T cells at multiple time points before and after 3 SARS-CoV-2 vaccinations were evaluated.
Results In ocrelizumab-treated patients (N = 24), IFN-γ–producing SARS-CoV-2–specific T-cell responses were induced after 2 vaccinations with median levels comparable to healthy controls (N = 12) and patients with MS without disease-modifying therapies (N = 10). A third vaccination in ocrelizumab-treated patients (N = 8) boosted T-cell responses that had declined after the second vaccination, but did not lead to higher overall T-cell responses as compared to immediately after a second vaccination. In fingolimod-treated patients, no SARS-CoV-2–specific T cells were detected after second (N = 12) and third (N = 9) vaccinations.
Discussion In ocrelizumab-treated patients with MS, a third SARS-CoV-2 vaccination had no additive effect on the maximal T-cell response but did induce a boost response. In fingolimod-treated patients, no T-cell responses could be detected following both a second and third SARS-CoV-2 vaccination.
Footnotes
↵* These authors contributed equally to the manuscript as first authors.
↵† These authors contributed equally as last authors.
The Article Processing Charge was funded by ZONMW (Dutch Organization for Health Research and Development).
Target-to-B! (T2B!) SARS-CoV-2 study group coinvestigators are listed in appendix 2 at the end of the article.
Go to Neurology.org/NN for full disclosures. Funding information is provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Scott S. Zamvil, MD, PhD, FAAN.
COVID-19 Resources: NPub.org/COVID19
- Received January 18, 2022.
- Accepted in final form March 30, 2022.
- Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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