2026-04-13T01:22:31Zhttps://recercat.cat/oai/request

oai:recercat.cat:10459.1/4642722025-09-15T18:37:26Zcom_2072_3622col_2072_479130

A prospective study of cellular immune response to booster COVID‑19 vaccination in multiple sclerosis patients treated with a broad spectrum of disease‑modifying therapies Torres Cabestany, Pascual Sancho Saldaña, Agustín Gil-Sánchez, Anna Peralta, Silvia Solana Moga, M. José Bakkioui, Sofian González Mingot, Cristina Quibus, Laura Ruiz Fernández, Emilio San Pedro‑Murillo, Eduardo Brieva Ruiz, Luis Multiple sclerosis Cellular immune response COVID-19 vaccines Immunomodulating drugs Booster revaccination Background Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs). As a result, immune responses to COVID-19 vaccinations could be compromised. There are few data on cellular immune responses to the use of COVID-19 vaccine boosters in pwMS under a broad spectrum of DMTs. Methods In this prospective study, we analysed cellular immune responses to SARS-CoV-2 mRNA booster vaccinations in 159 pwMS with DMT, including: ocrelizumab, rituximab, fingolimod, alemtuzumab, dimethyl fumarate, glatiramer acetate, teriflunomide, natalizumab and cladribine. Results DMTs, and particularly fingolimod, interact with cellular responses to COVID-19 vaccination. One booster dose does not increase cellular immunity any more than two doses, except in the cases of natalizumab and cladribine. SARS-CoV-2 infection combined with two doses of vaccine resulted in a greater cellular immune response, but this was not observed after supplementary booster jabs. Ocrelizumab-treated pwMS who had previously received fingolimod did not develop cellular immunity, even after receiving a booster. The time after MS diagnosis and disability status negatively correlated with cellular immunity in ocrelizumab-treated pwMS in a booster dose cohort. Conclusions After two doses of SARS-CoV-2 vaccination, a high response yield was achieved, except in patients who had received fingolimod. The effects of fingolimod on cellular immunity persisted for more than 2 years after a change to ocrelizumab (which, in contrast, conserved cellular immunity). Our results confirmed the need to find alternative protective measures for fingolimod-treated people and to consider the possible failure to provide protection against SARS-CoV-2 when switching from fingolimod to ocrelizumab. 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a https://doi.org/10.1007/s00415-023-11575-8 Journal of Neurology, 2023, vol. 270, p. 2380-2391 cc-by (c) Pascual Torres et al., 2023 Attribution 4.0 International info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/4.0/ Springer