The disease-modifying therapy (DMT) cladribine does not compromise the development of a specific humoral response in patients with multiple sclerosis (MS), according to a new study published in Multiple Sclerosis and Related Disorders.

“For ocrelizumab and fingolimod, a significant [antibody] response can be achieved with further vaccinations,” the authors of the study wrote.

These findings are important for the management of people with MS in terms of their DMT and future vaccinations, such as anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccinations. It was observed that people with MS on DMT had a blunted antibody response following anti-SARS-CoV-2 vaccination, suggesting a need for a booster dose.


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Here, a team of researchers led by Simona Rolla, PhD, from the Department of Clinical and Biological Sciences at the University of Turin in Italy evaluated the production kinetics of antireceptor binding domain immunoglobulin G (IgG) following an anti-SARS-CoV-2 vaccination cycle and the booster vaccination in patients with MS who were treated with ocrelizumab, fingolimod, or cladribine.

They found that there was a significant increase in receptor binding domain IgG seroconversion following the booster dose. According to the authors, these results suggest that a booster dose is fundamental in patients with MS who did not develop neutralizing antibodies after the first anti-SARS-CoV-2 vaccination cycle.

Future work in larger cohorts of patients is now necessary to better understand the effect of vaccination boosters in patients with MS in relation to DMT and future vaccination campaigns. DMTs aim to reduce the number and severity of MS relapses by dampening the immune response.

These treatments can therefore interfere with the immune response that vaccinations such as anti-SARS-CoV-2 aim to trigger. Despite this, the discontinuation of DMT is not recommended due to the high risk of relapse.

Reference

Maglione A, Morra M, Meroni R, Matta M, Clerico M, Rolla S. Humoral response after the booster dose of anti-SARS-CoV-2 vaccine in multiple sclerosis patients treated with high-efficacy therapies. Mult Scler Relat Disord. Published online March 26, 2022. doi:10.1016/j.msard.2022.103776