@article{a1d88035a93b48faaeb46494e4f131f3,
title = "Immune response to the third COVID-19 vaccine dose is related to lymphocyte count in multiple sclerosis patients treated with fingolimod",
abstract = "Background: The majority of multiple sclerosis [MS] patients treated with fingolimod fail to develop a protective level of IgG humoral and adaptive cellular immune responses following full BNT162b2 SARS-CoV-2 vaccination. Objective: To compare the efficacy of the third COVID-19 vaccine dose in vaccine non-responders fingolimod-treated MS patients. Study design: This is a prospective 3-month, single-center, randomized clinical trial. Methods: Twenty relapsing MS patients who had been on fingolimod therapy ≥ 12 months and failed to develop humoral IgG immune response to 2-dose Pfizer BNT162b2 COVID-19 vaccination were randomized into two groups: fingolimod-continuation group and fingolimod-discontinuation group. Humoral and memory cellular immune responses were assessed within 1 and 3 months following the third Pfizer BNT162b2 vaccine dose and compared between the groups. Results: A higher rate of patients in the fingolimod-discontinuation group [n = 8/10] compared to fingolimod-continuation group [n = 2/10] developed positive SARS-COV-2 IgG. Median IgG titer 1 month following the third dose was 202.3 BAU/ml vs. 26.4 BAU/ml, respectively, p = 0.022. The development of IgG humoral response correlated with absolute lymphocyte count. Specific SARS-COV-2 memory B cell and T cell immune responses were not detected in both groups, either at 1 month or 3 months following the third COVID-19 vaccine dose. Conclusions: Short period of fingolimod treatment discontinuation was associated with the development of humoral protection but not with adaptive cellular immunity.",
keywords = "COVID-19, Cellular immunity, Fingolimod, Humoral immunity, IgG antibody, Multiple sclerosis, Third BNT162b2 SARS-CoV-2 vaccine dose",
author = "Anat Achiron and Mathilda Mandel and Michael Gurevich and Sapir Dreyer-Alster and David Magalashvili and Polina Sonis and Mark Dolev and Shay Menascu and Gil Harari and Shlomo Flechter and Rina Falb",
note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.",
year = "2022",
month = may,
doi = "10.1007/s00415-022-11030-0",
language = "אנגלית",
volume = "269",
pages = "2286--2292",
journal = "Journal of Neurology",
issn = "0340-5354",
publisher = "D. Steinkopff-Verlag",
number = "5",
}