COVID-19 antibody response by vaccine type and lymphocyte count in RMS patients on ponesimod

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Background Various factors may impact the humoral response to coronavirus disease 2019 (COVID-19) vaccination in MS patients treated with S1P receptor modulators, including ponesimod. Objective Characterize SARS-CoV-2 humoral response by vaccine type and pre-vaccination lympho- cyte count in relapsing MS (RMS) patients who have received COVID-19 vaccination while on ponesimod treatment. Methods Patients in Phase 2 extension study receiving ponesimod 20 mg reported COVID-19 vaccination were included in this analysis. Blood samples collected before and at least 3 weeks after vaccination were evaluated with Human SARS-CoV-2 PreSpike IgG enzyme-linked immunoassay. Results Of 32 participants who received mRNA vaccines, 29 (90.6%) met responder criteria. Of 7 partic- ipants who received viral vector vaccines, 5 (71.4%) were responders. Of 6 participants who received inactivated virus vaccines, 2 (33.3%) were responders. Of 4 participants who received mixed or unspecified vaccine types, 4 (100%) were responders. Response to COVID-19 vaccination also varied by lymphocyte count: of 16 participants with pre-vaccination lymphocyte count <500/mm3, 9 (56.3%) were responders. Of 32 participants with lymphocyte count ≥500/mm3, 30 (93.8%) were responders. Conclusion Humoral response to COVID-19 vaccines in RMS patients on ponesimod in the Phase 2 study varied by vaccine type and pre-vaccination lymphocyte count.

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