Humoral Response to COVID-19 mRNA Vaccine in Patients With MS Receiving DMTs

Natalizumab, interferon beta, dimethyl fumarate, or diroximel fumarate but not ocrelizumab treatment for patients with multiple sclerosis (MS) was associated with preserved humoral response to the mRNA-1273 (Moderna) COVID-19 vaccine, according to study results presented at the 2022 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC) held from June 1-4, in National Harbor, Maryland.

Infection with SARS-CoV-2 can cause a severe respiratory illness which has been associated with millions of deaths worldwide. Vaccination is one of the best tools for curtailing the infection rates, however, immune response to vaccination can be affected by treatment with disease-modifying therapies (DMTs) which are commonly used to treat certain illnesses, including MS.

For this open-label, prospective, observational study funded by Biogen, patients receiving DMTs for MS were evaluated for response to the mRNA-1273 vaccine. Humoral response was evaluated using serum anti-receptor binding domain (RBD) of the spike glycoprotein of COVID-19 immunoglobulin G (IgG) levels at 8 and 24 weeks after the 1st vaccine dose.

Patients (N=45) were receiving ocrelizumab (n=16), natalizumab (n=12), dimethyl or diroximel fumarate (n=11), or interferon beta (n=6) for at least 6 months and were aged between 18 and 65 years.

At 8 weeks after the 1st mRNA-1273 vaccine dose, geometric mean titers (GMTs) of anti-RBD IgG were detectable and similar among all patients receiving natalizumab, interferon beta, and dimethyl or diroximel fumarate. Anti-RBD IgG GMTs continued to be detectable at 24 weeks but reduced by 81.5%.

For patients treated with ocrelizumab, only 25% generated detectable anti-RBD GMTs by 8 weeks after vaccination.

The major limitations of this study were the small sample sizes, the lack of a comparator group, and the short follow-up duration.

The study authors concluded that patients with MS treated with natalizumab, interferon beta, dimethyl fumarate, or diroximel fumarate had humoral responses to the first mRNA-1273 vaccine dose for COVID-19. Data about 36-week humoral and cellular responses are forthcoming.

“The relative importance of humoral and cell-mediated immunity to SARS-CoV-2 in the context of DMTs is crucial to understand, especially for [people with MS] who failed to seroconvert,” the researchers concluded.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Jaber A, Patel M, Sylvester A, et al. Immune Response to COVID-19 Vaccine in People With Multiple Sclerosis Treated With Dimethyl Fumarate, Diroximel Fumarate, Natalizumab, Ocrelizumab, or Interferon Therapy. Presented at: CMSC 2022 Annual Meeting; June 1-4, 2022; National Harbor, Maryland. Abstract DMT41.