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Antibody response to SARS-CoV-2 vaccination following typical and three-dose dosing schedules in multiple sclerosis patients treated with disease modifying therapies

•MS patients treated with most DMTs make a humoral response following a standard vaccination schedule.•Following a typical vaccination schedule against SARS-CoV2, 19% of patients on infusion anti-CD20 treatment made a humoral response; following an additional mRNA vaccination dose, 20% of patients o...

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Published in:Multiple sclerosis and related disorders 2022-07, Vol.63, p.103856-103856, Article 103856
Main Authors: Wallach, Asya I., Schiebel, Matthew, Picone, Mary Ann
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Schiebel, Matthew
Picone, Mary Ann
description •MS patients treated with most DMTs make a humoral response following a standard vaccination schedule.•Following a typical vaccination schedule against SARS-CoV2, 19% of patients on infusion anti-CD20 treatment made a humoral response; following an additional mRNA vaccination dose, 20% of patients on infusion anti-CD20 treatment made a humoral response.•MS patients treated with anti-CD20 infusions may have additional benefit from a third dose of SARS-CoV-2 mRNA vaccination. Background: Immunizations against SARS-CoV-2 virus are now available and recommended, but the effect of additional dosing of the vaccine in immunocompromised MS patients is unknown. Methods: Part I - A retrospective chart review of MS patients who were vaccinated against SARS-CoV-2 and tested commercially for Sars Covid Spike Protein Antibody between March 1 – June 30, 2021. Part II - Patients on treatment with anti-CD20 infusion medications who received a SARS-CoV-2 third mRNA vaccination dose August 13, 2021 – October 31, 2021 and were subsequently commercially tested for Sars Covid Spike Protein Antibody. Results: Part I - A total of N = 208 MS patients, age range 23–76 were tested, with 49% (102/208) demonstrating a humoral response. Stratified by DMT type, patients treated with interferon, teriflunomide, or a remote history of alemtuzumab (>2 years since last DMT) yielded 100% measurable antibodies; >90% amongst patients treated with natalizumab, fumarates and glatiramer acetate;
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Background: Immunizations against SARS-CoV-2 virus are now available and recommended, but the effect of additional dosing of the vaccine in immunocompromised MS patients is unknown. Methods: Part I - A retrospective chart review of MS patients who were vaccinated against SARS-CoV-2 and tested commercially for Sars Covid Spike Protein Antibody between March 1 – June 30, 2021. Part II - Patients on treatment with anti-CD20 infusion medications who received a SARS-CoV-2 third mRNA vaccination dose August 13, 2021 – October 31, 2021 and were subsequently commercially tested for Sars Covid Spike Protein Antibody. Results: Part I - A total of N = 208 MS patients, age range 23–76 were tested, with 49% (102/208) demonstrating a humoral response. Stratified by DMT type, patients treated with interferon, teriflunomide, or a remote history of alemtuzumab (&gt;2 years since last DMT) yielded 100% measurable antibodies; &gt;90% amongst patients treated with natalizumab, fumarates and glatiramer acetate; &lt;50% measurable antibodies following vaccination in S1P modulators and anti-CD20 treated patients. Subsequently, in Part II – N = 40 patients on anti-CD20 treatments (33 ocrelizumab, 7 rituximab) who received 3 mRNA vaccinations yielded 20% humoral response. Conclusions: MS patients are able to mount a humoral vaccine response to SARS-CoV-2, irrespective of the vaccine type administered; patients treated with S1P modulators and anti-CD20 agents are least likely to mount such a response with a typical dosing schedule. Patients treated with ocrelizumab/rituximab show a similar modest humoral immune system benefit following three doses as with standard dosing.</description><identifier>ISSN: 2211-0348</identifier><identifier>EISSN: 2211-0356</identifier><identifier>DOI: 10.1016/j.msard.2022.103856</identifier><identifier>PMID: 35636275</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Correspondence ; Covid-19 ; Disease modifying treatment ; Immunization ; Vaccine</subject><ispartof>Multiple sclerosis and related disorders, 2022-07, Vol.63, p.103856-103856, Article 103856</ispartof><rights>2022</rights><rights>Copyright © 2022. Published by Elsevier B.V.</rights><rights>2022 Elsevier B.V. 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Background: Immunizations against SARS-CoV-2 virus are now available and recommended, but the effect of additional dosing of the vaccine in immunocompromised MS patients is unknown. Methods: Part I - A retrospective chart review of MS patients who were vaccinated against SARS-CoV-2 and tested commercially for Sars Covid Spike Protein Antibody between March 1 – June 30, 2021. Part II - Patients on treatment with anti-CD20 infusion medications who received a SARS-CoV-2 third mRNA vaccination dose August 13, 2021 – October 31, 2021 and were subsequently commercially tested for Sars Covid Spike Protein Antibody. Results: Part I - A total of N = 208 MS patients, age range 23–76 were tested, with 49% (102/208) demonstrating a humoral response. Stratified by DMT type, patients treated with interferon, teriflunomide, or a remote history of alemtuzumab (&gt;2 years since last DMT) yielded 100% measurable antibodies; &gt;90% amongst patients treated with natalizumab, fumarates and glatiramer acetate; &lt;50% measurable antibodies following vaccination in S1P modulators and anti-CD20 treated patients. Subsequently, in Part II – N = 40 patients on anti-CD20 treatments (33 ocrelizumab, 7 rituximab) who received 3 mRNA vaccinations yielded 20% humoral response. Conclusions: MS patients are able to mount a humoral vaccine response to SARS-CoV-2, irrespective of the vaccine type administered; patients treated with S1P modulators and anti-CD20 agents are least likely to mount such a response with a typical dosing schedule. Patients treated with ocrelizumab/rituximab show a similar modest humoral immune system benefit following three doses as with standard dosing.</description><subject>Correspondence</subject><subject>Covid-19</subject><subject>Disease modifying treatment</subject><subject>Immunization</subject><subject>Vaccine</subject><issn>2211-0348</issn><issn>2211-0356</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9UU1r3DAUNKWlCWl-QaHo2Iu3kmzZ8qGFZekXBApN0quQpedYiyy5krxhf1D-Z7TZdGkv1UES783Me8wUxVuCVwST5sN2NUUZ9IpiSnOl4qx5UZxTSkiJK9a8PP1rflZcxrjF-TSM1A15XZxlRNXQlp0XD2uXTO_1HgWIs3cRUPLoev3zutz4XyVFO6mUcTIZ79DgrfX3xt2htJ-NkhZJp1EaA0Cpfabm69CNagS9WIjIODQtNpnZQq5aCBkQ0ZzlwKWIUgCZQKN7k0akTQSZRSavzbB_mjJCkLOB-KZ4NUgb4fL5vShuv3y-2Xwrr358_b5ZX5Wq4l0q65bxFkObHSJ9zVpGGFds6IHVXdcxqWSLG8kpaKYH2Qy4V5zTTuNhwLjnVXVRfDrqzks_gVZ5ySCtmIOZZNgLL434t-PMKO78TnS4pZy0WeD9s0DwvxeISUwmKrBWOvBLFLRpyWGVGmdodYSqbEoMMJzGECwOGYuteMpYHDIWx4wz693fG544fxLNgI9HAGSfdgaCiCqbrUCbACoJ7c1_BzwCnau9sA</recordid><startdate>20220701</startdate><enddate>20220701</enddate><creator>Wallach, Asya I.</creator><creator>Schiebel, Matthew</creator><creator>Picone, Mary Ann</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220701</creationdate><title>Antibody response to SARS-CoV-2 vaccination following typical and three-dose dosing schedules in multiple sclerosis patients treated with disease modifying therapies</title><author>Wallach, Asya I. ; Schiebel, Matthew ; Picone, Mary Ann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-475870e71011b4575158c5fbe549995aca706a82ed5dfa6f0bc8829d0ff00b833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Correspondence</topic><topic>Covid-19</topic><topic>Disease modifying treatment</topic><topic>Immunization</topic><topic>Vaccine</topic><toplevel>online_resources</toplevel><creatorcontrib>Wallach, Asya I.</creatorcontrib><creatorcontrib>Schiebel, Matthew</creatorcontrib><creatorcontrib>Picone, Mary Ann</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Multiple sclerosis and related disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallach, Asya I.</au><au>Schiebel, Matthew</au><au>Picone, Mary Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antibody response to SARS-CoV-2 vaccination following typical and three-dose dosing schedules in multiple sclerosis patients treated with disease modifying therapies</atitle><jtitle>Multiple sclerosis and related disorders</jtitle><addtitle>Mult Scler Relat Disord</addtitle><date>2022-07-01</date><risdate>2022</risdate><volume>63</volume><spage>103856</spage><epage>103856</epage><pages>103856-103856</pages><artnum>103856</artnum><issn>2211-0348</issn><eissn>2211-0356</eissn><abstract>•MS patients treated with most DMTs make a humoral response following a standard vaccination schedule.•Following a typical vaccination schedule against SARS-CoV2, 19% of patients on infusion anti-CD20 treatment made a humoral response; following an additional mRNA vaccination dose, 20% of patients on infusion anti-CD20 treatment made a humoral response.•MS patients treated with anti-CD20 infusions may have additional benefit from a third dose of SARS-CoV-2 mRNA vaccination. Background: Immunizations against SARS-CoV-2 virus are now available and recommended, but the effect of additional dosing of the vaccine in immunocompromised MS patients is unknown. Methods: Part I - A retrospective chart review of MS patients who were vaccinated against SARS-CoV-2 and tested commercially for Sars Covid Spike Protein Antibody between March 1 – June 30, 2021. Part II - Patients on treatment with anti-CD20 infusion medications who received a SARS-CoV-2 third mRNA vaccination dose August 13, 2021 – October 31, 2021 and were subsequently commercially tested for Sars Covid Spike Protein Antibody. Results: Part I - A total of N = 208 MS patients, age range 23–76 were tested, with 49% (102/208) demonstrating a humoral response. Stratified by DMT type, patients treated with interferon, teriflunomide, or a remote history of alemtuzumab (&gt;2 years since last DMT) yielded 100% measurable antibodies; &gt;90% amongst patients treated with natalizumab, fumarates and glatiramer acetate; &lt;50% measurable antibodies following vaccination in S1P modulators and anti-CD20 treated patients. Subsequently, in Part II – N = 40 patients on anti-CD20 treatments (33 ocrelizumab, 7 rituximab) who received 3 mRNA vaccinations yielded 20% humoral response. Conclusions: MS patients are able to mount a humoral vaccine response to SARS-CoV-2, irrespective of the vaccine type administered; patients treated with S1P modulators and anti-CD20 agents are least likely to mount such a response with a typical dosing schedule. Patients treated with ocrelizumab/rituximab show a similar modest humoral immune system benefit following three doses as with standard dosing.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>35636275</pmid><doi>10.1016/j.msard.2022.103856</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Correspondence
Covid-19
Disease modifying treatment
Immunization
Vaccine
title Antibody response to SARS-CoV-2 vaccination following typical and three-dose dosing schedules in multiple sclerosis patients treated with disease modifying therapies
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