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Multiple SclerosisNCT05060354

COVID-19 Vaccine Response in Treated MS Patients

An observational study of Multiple Sclerosis and Healthy, run by Brigham and Women's Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary goal of this study is to assess the impact of the two major disease modifying therapy (DMT) classes (B cell therapies and S1P modulators) on humoral and cell-mediated immunity to SARS- CoV-2 vaccination compared to non-MS controls. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Multiple Sclerosis, Healthy
What is being tested?
Blood draw
Type of treatment
Vaccines
How many people
159 participants
Where
1 siteUnited States
Study dates
1 Jun 2021to 28 Sep 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: For this study, we will prospectively collect data and biospecimens from MS patients and healthy volunteers. MS patients will largely be recruited from the Brigham MS Center at Brigham and Women's Hospital (Boston MA US). Healthy volunteers will be recruited from the community surrounding BWH and through IRB-approved recruitment advertisements. The Brigham MS Center sees 2500 patients annually and is adjacent to an ongoing COVID vaccine clinic.

Who may be able to join

  • For MS Patients:
  • Diagnosis of MS
  • Treatment with one of the four DMTs (Kesimpta (ofatumumab), Ocrevus (ocrelizumab), Gilenya (fingolimod), Mayzent (siponimod)) for at least 3 months prior to first SARS-CoV2 vaccine dose
  • SARS-CoV2 vaccine regimen complete within the past 2-3 or 5-6 months (either Moderna® or Pfizer-BioNTech® mRNA vaccines)
  • Age 18-65, inclusive
  • For Health Controls:
  • 1. Age 18-65, inclusive

Who cannot join

  • For MS Patients:
  • 1. Prior known COVID-19 infection
  • For Health Controls:
  • Prior known COVID-19 infection
  • major autoimmune disorders or current treatment with immunosuppressive or immunomodulatory drugs

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Brigham MS Center

    Boston, Massachusetts, 02115

Other trials in United States

About this study

Official title: Immune Response to SARS-CoV2 Vaccinations in Treated MS Patients Compared to Controls

The primary goal of this study is to assess the impact of the two major disease modifying therapy (DMT) classes (B cell therapies and S1P modulators) on humoral and cell-mediated immunity to SARS- CoV-2 vaccination compared to non-MS controls. We have chosen to compare DMT-treated MS patients to non-MS controls because the pivotal vaccine studies were conducted in non-MS healthy control groups in which there is significant clinical data and validated assays for antibody responses.

Read the detailed description

Multiple sclerosis (MS) affects approximately 1 million persons in the United States and is the leading cause of disability in young adults. Disease modifying treatments for MS act through modulation or suppression of immune responses including B and T cell responses. Two major classes of drugs used to treat MS are 1) B cell antibodies, including Kesimpta (ofatumumab) and Ocrevus (ocrelizumab), and 2) S1P (sphingosine-1-phosphate) modulators including Gilenya (fingolimod) and Mayzent (siponimod). SARS-CoV2 is a potentially fatal novel coronavirus, which has claimed over 350,000 lives in the United States. The causative agent of COVID-19 disease, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes the angiotensin converting enzyme II (ACE2) to target cells in the lower airway.(1, 2) Symptoms of COVID-19 infection can cause pneumonia with primarily lymphocytic inflammatory infiltrates.(3) Most people (approximately 81%) experience mild upper respiratory tract infection or mild pneumonia, while approximately 15-20% of cases experience severe or critical disease characterized by dyspnea, lung infiltrates, respiratory failure and multiple organ dysfunction.(4) The case- fatality rate ranges from 0.7-5.8%. SARS-CoV2 vaccines have just been FDA approved, including the Moderna® and Pfizer-BioNTech® vaccines which contain lipid nanoparticle- formulated nucleoside-modified mRNA (messenger ribonucleic acid) that encodes the receptor binding domain (RBD) of the SARS-CoV-2 spike protein.(5, 6) Prior work suggests that vaccine responses may be blunted in patients treated with these two drug classes, however there is currently no controlled data on the efficacy and durability of SARS-CoV2 vaccine responses in treated MS patients. Current data is limited to uncontrolled case reports.

Robust studies are needed to inform the efficacy of SARS-CoV2 vaccines in MS patients on DMTs, which will guide infection risk management.

The primary goal of this study is to assess the impact of the two major DMT classes (B cell therapies and S1P modulators) on humoral and cell-mediated immunity to SARS- CoV-2 vaccination compared to non-MS controls. We have chosen to compare DMT-treated MS patients to non-MS controls because the pivotal vaccine studies were conducted in non-MS healthy control groups in which there is significant clinical data and validated assays for antibody responses.

The primary endpoint of this study is to compare the percentage of MS patients on immunotherapy with a positive SARS-CoV-2 Spike antibody response (positive seroconversion) compared to the percentage of controls who seroconvert at 5-6 months post vaccination.

Secondary endpoints of this study are:

  • Comparison of SARS-CoV-2 Spike antibody % seroconversion and titers in MS patients on immunotherapy to titers in controls at 2-3 months and 11-12 months post vaccination.
  • Comparison of T cell responses to SARS-CoV-2 spike protein in MS patients on immunotherapy to titers in controls at 5-6 months post vaccination.
  • Comparison of antibody titers and T cell responses between the four groups of immunotherapies evaluated and to controls at each of the three timepoints.
Being tested
Blood draw
Keywords
Multiple Sclerosis, COVID-19, mRNA vaccine
Medical subject headings
Multiple Sclerosis, COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood drawOther

    Approximately 120 mL whole blood will be collected from each subject at each timepoint

Study groups in NCT05060354
Study groupRoleWhat they receive
MS Kesimpta (ofatumumab)MS patients treated with Kesimpta (ofatumumab) for at least 3 months prior to SARS-CoV2 vaccination (completed regimen) Drug administration n/a, following routine clinical care Blood draws at 2-3 months, 5-6 months, and 11-12 months after enrollment
Receives: Other: Blood draw
MS Ocrevus (ocrelizumab)MS patients treated with Ocrevus (ocrelizumab) for at least 3 months prior to SARS-CoV2 vaccination (completed regimen) Drug administration n/a, following routine clinical care Blood draws at 2-3 months, 5-6 months, and 11-12 months after enrollment
Receives: Other: Blood draw
MS Gilenya (fingolimod) and Mayzent (siponimod)MS patients treated with Gilenya (fingolimod) or Mayzent (siponimod) for at least 3 months prior to SARS-CoV2 vaccination (completed regimen) Drug administration n/a, following routine clinical care Blood draws at 2-3 months, 5-6 months, and 11-12 months after enrollment
Receives: Other: Blood draw
Healthy ControlIndividuals with major autoimmune disorders or current treatment with immunosuppressive or immunomodulatory drugs Received SARS-CoV2 vaccination (completed regimen) within 2-6 months of enrollment Blood draws at 2-3 months, 5-6 months, and 11-12 months after enrollment
Receives: Other: Blood draw

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Primary endpoint

    Compare the percentage of MS patients on immunotherapy with a positive SARS-CoV-2 Spike antibody response, using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay for the quantitative, in vitro determination of antibodies to SARS-CoV- 2 in human serum and plasma. It is an Electro-chemiluminescence immunoassay (ECLIA) test using a double-antigen sandwich assay. A positive seroconversion defined as level>0.4U/ml.

    Measured: 11-12 months

Secondary outcomes (5)
  1. Secondary endpoint 1

    Comparison of SARS-CoV-2 Spike antibody % seroconversion and titers in MS patients on immunotherapy to titers in controls at 2-3 months and 11-12 months post vaccination. This will be measured as a percentage.

    Measured: 11-12 months

  2. Secondary endpoint 2

    Comparison of percentage of IFN-gamma positive CD4+ T cells measured by flow cytometry reactive to SARS-CoV-2 spike protein in MS patients on immunotherapy to titers in controls at 5-6 months post vaccination.

    Measured: 5-6 months

  3. Secondary endpoint 3

    Comparison of antibody titers and percentage of IFN-gamma positive CD4+ T cells reactive to SARS-CoV-2 measured by flow cytometry between the four groups of immunotherapies evaluated and to controls at each of the three timepoints 2-3, 5-6, and 11-12 months.

    Measured: 11-12 months

  4. Secondary endpoint 4

    Comparison of SARS-CoV-2 Spike antibody seroconversion and levels in MS patients on immunotherapy after 2 vaccine doses versus 3 or more vaccine doses, as measured by Roche Elecsys® Anti-SARS-CoV-2 S immunoassay, with a positive seroconversion defined as >0.4U/ml.

    Measured: 11-12 months

  5. Secondary endpoint 5

    Comparison of percentage SARS-CoV-2 reactive IFN-gamma positive CD4+ T cells measured by flow cytometry in MS patients on immunotherapy after 2 vaccine doses versus 3 or more vaccine doses.

    Measured: 11-12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Sep 2021
  2. Study start1 Jun 2021
  3. Primary completion15 Sep 2023
  4. Study completion28 Sep 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
159 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05060354
Sponsor's protocol ID
COMB157GUS19T
Status last verified
Jan 2024
First submitted
27 Sep 2021
Last updated
25 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

    PubMed 31986264
  • Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL, Chen HD, Chen J, Luo Y, Guo H, Jiang RD, Liu MQ, Chen Y, Shen XR, Wang X, Zheng XS, Zhao K, Chen QJ, Deng F, Liu LL, Yan B, Zhan FX, Wang YY, Xiao GF, Shi ZL. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar;579(7798):270-273. doi: 10.1038/s41586-020-2012-7. Epub 2020 Feb 3.

    PubMed 32015507
  • Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Apr;8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X. Epub 2020 Feb 18. No abstract available.

    PubMed 32085846
  • Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. No abstract available.

    PubMed 32091533
  • Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech CB, McGettigan J, Khetan S, Segall N, Solis J, Brosz A, Fierro C, Schwartz H, Neuzil K, Corey L, Gilbert P, Janes H, Follmann D, Marovich M, Mascola J, Polakowski L, Ledgerwood J, Graham BS, Bennett H, Pajon R, Knightly C, Leav B, Deng W, Zhou H, Han S, Ivarsson M, Miller J, Zaks T; COVE Study Group. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2021 Feb 4;384(5):403-416. doi: 10.1056/NEJMoa2035389. Epub 2020 Dec 30.

    PubMed 33378609
  • Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Perez Marc G, Moreira ED, Zerbini C, Bailey R, Swanson KA, Roychoudhury S, Koury K, Li P, Kalina WV, Cooper D, Frenck RW Jr, Hammitt LL, Tureci O, Nell H, Schaefer A, Unal S, Tresnan DB, Mather S, Dormitzer PR, Sahin U, Jansen KU, Gruber WC; C4591001 Clinical Trial Group. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020 Dec 31;383(27):2603-2615. doi: 10.1056/NEJMoa2034577. Epub 2020 Dec 10.

    PubMed 33301246
  • Conway S, Saxena S, Baecher-Allan C, Krishnan R, Houtchens M, Glanz B, Saraceno TJ, Polgar-Turcsanyi M, Bose G, Bakshi R, Bhattacharyya S, Galetta K, Kaplan T, Severson C, Singhal T, Stazzone L, Zurawski J, Paul A, Weiner HL, Healy BC, Chitnis T. Preserved T cell but attenuated antibody response in MS patients on fingolimod and ocrelizumab following 2nd and 3rd SARS-CoV-2 mRNA vaccine. Mult Scler J Exp Transl Clin. 2023 Apr 5;9(2):20552173231165196. doi: 10.1177/20552173231165196. eCollection 2023 Apr-Jun.

    PubMed 37057191

Questions about this trial

What is this clinical trial studying?

An observational study of Multiple Sclerosis and Healthy, run by Brigham and Women's Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Primary endpoint (time frame: 11-12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05060354, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jan 2024.

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