All multiple sclerosis (MS) patients should have the COVID-19 vaccine, as suggested by the National Multiple Sclerosis Society and other authoritative groups. Researchers are looking at how disease-modifying treatments affect the body’s ability to mount healthy responses against infection. The goal of this study was to describe the humoral and cellular immune responses of people who received the mRNA-COVID-19 MS vaccination and were subsequently given Teriflunomide. Before, 1, and 3 months after the second dose of the BNT162b2-COVID-19 vaccine, researchers prospectively measured SARS-COV-2 IgG response using a quantitative anti-spike protein-based immunoassay (Euroimmun, Lubeck, Germany, cut-off IgG level >35.2 BAU/ml), memory B-cells specific for SARS-CoV-2 RBD, and memory T-cells secreting IFN-g and 31 patients were untreated (21 of them women), whereas 30 patients (23 of them women) were taking Teriflunomide for a median of 3.7 years (range: 1.5-7.0). The antibody titer, as well as cellular B and T cell responses, were measured, as well as the percentage of participants who generated protective antibodies. Neither a clinical case of SARS-CoV-2 nor any indication of earlier infection in the form of an immune response was found in any of the patients. Both untreated and Teriflunomide-treated MS patients had comparable spike IgG titers 1 month after the second vaccination dose (median 1,320.7, 25-75 IQR 850.9-3,152.8 vs. median 901.7, 25-75 IQR 618.5-1,495.8, BAU/ml) and 3 months after the second vaccine dose (median 1,388.8, 25-75 IQR 1,064.6-2,347.6). At 1 month after vaccination, distinct SARS-COV-2 memory B cells were found in 41.9% of participants in the untreated MS group and in 40.0% of subjects in the Teriflunomide-treated MS group. At 1 month, 48.4% of untreated and 46.7% of Teriflunomide-treated MS patients had specific SARS-COV-2 memory T cells, whereas at 3 months, 41.9% of untreated and 56.7% of Teriflunomide-treated MS patients had these cells. Immune responses to the COVID-19 vaccine were both humoral and cellular after treatment with teriflunomide.
Reference: ECTRIMS 2022