{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:36:22Z","timestamp":1788957382349,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This epidemiologic cohort study documented clinical and serological data in MS patients over several vaccination cycles against severe respiratory syndrome coronavirus-2 (SARS-CoV-2) in a real-world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients with MS were included during a period of 26 months from July 2021 if SARS-CoV-2 vaccination was planned, or first dose was given, or vaccination was completed within the last 6 weeks, or vaccination was completed &amp;gt;6 weeks ago and a booster dose was planned within the next 90 days. Humoral immune response to authorized SARS-CoV-2 vaccines was investigated during each vaccination cycle at baseline and approximately 1 and 6 months after vaccination. Immune response was defined as an anti-SARS-CoV-2 spike protein IgG titer &amp;gt;100 BAU\/ml above pre-vaccination level and, separately, by the presence of SARS-CoV-2 neutralizing antibodies (NAb) approximately 1 month after the last vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 159 patients enrolled, 140 (88.1%) were being treated with a DMT. Most patients (67.9%,\n                      <jats:italic>n<\/jats:italic>\n                      = 108) entered the study after complete initial SARS-CoV-2 vaccination (up to two doses) and before the 1st booster dose. Approximately 1 month after the 1st booster vaccination, response was seen in 68.1% of the patients (\n                      <jats:italic>n<\/jats:italic>\n                      = 79\/116) based on anti-S1-IgG increase and in 72.1% (\n                      <jats:italic>n<\/jats:italic>\n                      = 88\/122) based on NAb seropositivity. Persisting immune response approximately 6 months after vaccination was observed in 71.8% (\n                      <jats:italic>n<\/jats:italic>\n                      = 51\/71) and in 93.7% (\n                      <jats:italic>n<\/jats:italic>\n                      = 74\/79) of the responders, respectively. Adequate humoral immune response and persistence of response was less frequent in patients on anti-CD20 antibodies or sphingosine-1-phosphate receptor (S1PR) modulators compared to patients on other DMTs or DMT-untreated patients. Breakthrough infections with the SARS-CoV-2 virus were reported in 58 patients (36.5%). Seven patients (4.4%) experienced an MS relapse during the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With the exception of anti-CD20 antibodies and S1PR modulators, DMTs did not impair humoral response to any of the authorized SARS-CoV-2 vaccines. Persistence of humoral immune response was seen over a period of at least 3 months in the majority of initial responders but was decreased in the anti-CD20 antibodies\/S1PR modulator subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>This epidemiological study is registered in the German Clinical Trials Register (DRKS00025893).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1674742","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:20:17Z","timestamp":1761744017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A multicenter, prospective cohort study on the anti-SARS-CoV-2 vaccination response in patients with multiple sclerosis in Germany"],"prefix":"10.3389","volume":"16","author":[{"given":"Achim","family":"Berthele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"G\u00f6del","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris-Alexander","family":"Kallmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kowarik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Lehmann-Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Marziniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Rauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit","family":"Rothhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian Then","family":"Bergh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Wahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Wildemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ksenija","family":"Schirduan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e24294","DOI":"10.7759\/cureus.24294","article-title":"Multiple sclerosis and autoimmunity: a veiled relationship","volume":"14","author":"Barkhane","year":"2022","journal-title":"Cureus."},{"key":"B2","doi-asserted-by":"publisher","first-page":"a028936","DOI":"10.1101\/cshperspect.a028936","article-title":"Multiple sclerosis pathology","volume":"8","author":"Lassmann","year":"2018","journal-title":"Cold Spring Harb Perspect Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1007\/s11910-021-01110-5","article-title":"Chronic demyelination and axonal degeneration in multiple sclerosis: pathogenesis and therapeutic implications","volume":"21","author":"Simkins","year":"2021","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/S0140-6736(94)91118-5","article-title":"Pathogenesis of multiple sclerosis","volume":"343","author":"Ffrench-Constant","year":"1994","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1007\/s11910-017-0800-8","article-title":"Infections in patients receiving multiple sclerosis disease-modifying therapies","volume":"17","author":"Grebenciucova","year":"2017","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1001\/jamaneurol.2019.3365","article-title":"Infection risks among patients with multiple sclerosis treated with fingolimod, natalizumab, rituximab, and injectable therapies","volume":"77","author":"Luna","year":"2020","journal-title":"JAMA Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.neurol.2019.08.012","article-title":"What are the infectious risks with disease-modifying drugs for multiple sclerosis and how to reduce them? 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