tetano
Editor, Senior Moderator
Eur J Med Res
. 2024 Jan 5;29(1):28.
doi: 10.1186/s40001-023-01620-7. Biological and glucocorticoids treatment impair the medium-term immunogenicity to SARS-CoV-2 mRNA vaccines in autoimmune inflammatory rheumatic diseases
Silvia Garcia-Cirera[SUP] 1 2 [/SUP], Joan Calvet[SUP] 3 4 [/SUP], Juan Francisco Delgado de la Poza[SUP] 5 [/SUP], Antoni Berenguer-Llergo[SUP] 6 [/SUP], Cristóbal Orellana[SUP] 1 [/SUP], Menna Rusiñol[SUP] 1 [/SUP], Maria Llop[SUP] 1 [/SUP], Marta Arévalo[SUP] 1 [/SUP], Alba Garcia-Pinilla[SUP] 1 [/SUP], Ester Costa[SUP] 1 [/SUP], Cristina Aymerich[SUP] 1 [/SUP], Rafael Gómez[SUP] 1 [/SUP], Anna Carreras[SUP] 1 [/SUP], Jordi Gratacós[SUP] 1 2 [/SUP]
Affiliations
Background: This study aims to assess the sustained immunological response to the SARS-CoV-2 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIRD) undergoing different treatment regimens.
Methods: We conducted a prospective observational study involving 157 AIRD patients without prior COVID-19 infection. Treatment regimens included non-treatment or glucocorticoid-only (not-treated/GCs), non-biological drugs, biological therapy, and JAK inhibitors. All participants completed the two-dose vaccine schedule, and 110 of them received an additional booster dose. Serum samples were collected approximately 3-6 months after the second and third vaccine doses to measure antibodies against the Spike protein (antiS-AB) and neutralizing antibodies (nAB) targeting six SARS-CoV-2 variants.
Results: Following the third dose, all patients exhibited a significant increase in antiS-AB (FC = 15, p < 0.0001). Patients under biological therapy had lower titres compared to the non-biological (66% decrease, p = 0.038) and the not-treated/GCs group (62% decrease, p = 0.0132), with the latter persisting after the booster dose (86% decrease, p = 0.0027). GC use was associated with lower antiS-AB levels in the biological group (87% decrease, p = 0.0124), although not statistically significant after confounders adjustment. nABs showed the highest positivity rates for the wild-type strain before (50%) and after the booster dose (93%), while the Omicron variant exhibited the lowest rates (11% and 55%, respectively). All variants demonstrated similar positivity patterns and good concordance with antiS-AB (AUCs from 0.896 to 0.997).
Conclusions: The SARS-CoV-2 vaccine booster strategy effectively elicited a sustained antibody immune response in AIRD patients. However, patients under biological therapies exhibited a reduced response to the booster dose, particularly when combined with GCs.
Keywords: Autoimmune disease; COVID19; Immune response; Neutralizing antibodies.
. 2024 Jan 5;29(1):28.
doi: 10.1186/s40001-023-01620-7. Biological and glucocorticoids treatment impair the medium-term immunogenicity to SARS-CoV-2 mRNA vaccines in autoimmune inflammatory rheumatic diseases
Silvia Garcia-Cirera[SUP] 1 2 [/SUP], Joan Calvet[SUP] 3 4 [/SUP], Juan Francisco Delgado de la Poza[SUP] 5 [/SUP], Antoni Berenguer-Llergo[SUP] 6 [/SUP], Cristóbal Orellana[SUP] 1 [/SUP], Menna Rusiñol[SUP] 1 [/SUP], Maria Llop[SUP] 1 [/SUP], Marta Arévalo[SUP] 1 [/SUP], Alba Garcia-Pinilla[SUP] 1 [/SUP], Ester Costa[SUP] 1 [/SUP], Cristina Aymerich[SUP] 1 [/SUP], Rafael Gómez[SUP] 1 [/SUP], Anna Carreras[SUP] 1 [/SUP], Jordi Gratacós[SUP] 1 2 [/SUP]
Affiliations
- PMID: 38183092
- PMCID: PMC10768211
- DOI: 10.1186/s40001-023-01620-7
Background: This study aims to assess the sustained immunological response to the SARS-CoV-2 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIRD) undergoing different treatment regimens.
Methods: We conducted a prospective observational study involving 157 AIRD patients without prior COVID-19 infection. Treatment regimens included non-treatment or glucocorticoid-only (not-treated/GCs), non-biological drugs, biological therapy, and JAK inhibitors. All participants completed the two-dose vaccine schedule, and 110 of them received an additional booster dose. Serum samples were collected approximately 3-6 months after the second and third vaccine doses to measure antibodies against the Spike protein (antiS-AB) and neutralizing antibodies (nAB) targeting six SARS-CoV-2 variants.
Results: Following the third dose, all patients exhibited a significant increase in antiS-AB (FC = 15, p < 0.0001). Patients under biological therapy had lower titres compared to the non-biological (66% decrease, p = 0.038) and the not-treated/GCs group (62% decrease, p = 0.0132), with the latter persisting after the booster dose (86% decrease, p = 0.0027). GC use was associated with lower antiS-AB levels in the biological group (87% decrease, p = 0.0124), although not statistically significant after confounders adjustment. nABs showed the highest positivity rates for the wild-type strain before (50%) and after the booster dose (93%), while the Omicron variant exhibited the lowest rates (11% and 55%, respectively). All variants demonstrated similar positivity patterns and good concordance with antiS-AB (AUCs from 0.896 to 0.997).
Conclusions: The SARS-CoV-2 vaccine booster strategy effectively elicited a sustained antibody immune response in AIRD patients. However, patients under biological therapies exhibited a reduced response to the booster dose, particularly when combined with GCs.
Keywords: Autoimmune disease; COVID19; Immune response; Neutralizing antibodies.