Longitudinal T-Cell Responses After a Third SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis on Ocrelizumab or Fingolimod.Palomares Cabeza V, Kummer LYL, Wieske L, Hagen RR, Duurland M, Konijn VAL, van Dam KPJ, Stalman EW, van de Sandt CE, Boekel L, Verstegen NJM, Steenhuis M, Rispens T, Tas SW, Wolbink G, Killestein J, Kuijpers TW, van Ham SM, Eftimov F, Brinke AT, van Kempen ZLE; Target-to-B! (T2B!) SARS-CoV-2 study group.Neurol Neuroimmunol Neuroinflamm. 2022 May 6;9(4):e1178.
Objectives: To evaluate whether a third vaccination shows an added effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) T-cell responses in patients with multiple sclerosis treated with ocrelizumab or fingolimod.
Methods: This is a substudy of a prospective multicenter study on SARS-CoV-2 vaccination in patients with immune-mediated diseases. Patients with MS treated with ocrelizumab, fingolimod, and no disease-modifying therapies and healthy controls were included. The number of interferon (IFN)-γ secreting SARS-CoV-2-specific T cells at multiple time points before and after 3 SARS-CoV-2 vaccinations were evaluated.
Results: In ocrelizumab-treated patients (N = 24), IFN-γ-producing SARS-CoV-2-specific T-cell responses were induced after 2 vaccinations with median levels comparable to healthy controls (N = 12) and patients with MS without disease-modifying therapies (N = 10). A third vaccination in ocrelizumab-treated patients (N = 8) boosted T-cell responses that had declined after the second vaccination, but did not lead to higher overall T-cell responses as compared to immediately after a second vaccination. In fingolimod-treated patients, no SARS-CoV-2-specific T cells were detected after second (N = 12) and third (N = 9) vaccinations.
Discussion: In ocrelizumab-treated patients with MS, a third SARS-CoV-2 vaccination had no additive effect on the maximal T-cell response but did induce a boost response. In fingolimod-treated patients, no T-cell responses could be detected following both a second and third SARS-CoV-2 vaccination.
So confirmation of our and other results in that the third vaccination doesnt make many more people seroconvert with ocrelizumab or fingolimod. There is a T cell response from blood cells with ocrelizumab but not with fingolimod. So I think the i is dotted and the t is crossed. Don’t expect much more from the forth vaccination. We have already seen this data from other immunosuppressed conditions. So the big question we have to explain is what is happening with fingolimod. Will the same happen with the other imods…I am predicting they wont be as bad….but let’s see the data.
COI: None relevent except we have reported this already
Disclaimer: These are the authors views and only the authors views