Serological response to SARS-CoV-2 vaccination in multiple sclerosis patients treated with fingolimod or ocrelizumab: an initial real-life experience

J Neurol. 2022 Jan;269(1):39-43. doi: 10.1007/s00415-021-10663-x. Epub 2021 Jun 26.

Abstract

Background: Recent observations suggest a lack of humoral response after SARS-CoV-2 vaccination in multiple sclerosis (MS) patients treated with fingolimod or ocrelizumab OBJECTIVES: To assess serological response to SARS-CoV-2 vaccination in MS patients receiving these disease-modifying treatments (DMTs) in a real-life setting.

Methods: Retrospective clinical data collection from MS patients followed at San Raffaele Hospital MS Centre (Milan, Italy). All patients treated with fingolimod or ocrelizumab who had received a complete anti-COVID-19 vaccination course, with no clinical history suggestive of previous SARS-CoV-2 infection and with an available post-vaccination serological assay obtained at least 14 days after vaccination completion were considered for the study.

Results: We collected data from 32 MS patients, 16 treated with fingolimod and 16 receiving ocrelizumab. Among the fingolimod group 10 patients (62.5%) had a positive serological response after vaccination and among ocrelizumab-treated patients a positive serological test was found in six cases (37.5%). No relation between serological response and clinical features (i.e., treatment duration, time between vaccination and last treatment dose, and white blood cells count) was identified.

Conclusions: Our initial real-life experience suggests a variable antibody production in MS patients receiving these DMTs. At present, there are no sufficient data to do not recommend anti-SARS-CoV-2 vaccine in these patients.

Keywords: COVID-19; Fingolimod; Multiple sclerosis; Ocrelizumab; SARS-CoV-2 vaccination.

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antibodies, Viral / blood
  • COVID-19 Vaccines / immunology*
  • COVID-19*
  • Fingolimod Hydrochloride / therapeutic use
  • Humans
  • Immunity, Humoral
  • Italy
  • Multiple Sclerosis* / drug therapy
  • Retrospective Studies
  • Vaccination

Substances

  • Antibodies, Monoclonal, Humanized
  • Antibodies, Viral
  • COVID-19 Vaccines
  • ocrelizumab
  • Fingolimod Hydrochloride