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Different humoral but similar cellular responses of patients with autoimmune inflammatory rheumatic diseases under disease-modifying antirheumatic drugs after COVID-19 vaccination.
Andreica, Ioana; Blazquez-Navarro, Arturo; Sokolar, Jan; Anft, Moritz; Kiltz, Uta; Pfaender, Stephanie; Vidal Blanco, Elena; Westhoff, Timm; Babel, Nina; Stervbo, Ulrik; Baraliakos, Xenofon.
  • Andreica I; Ruhr-Universität Bochum, Bochum, Germany Ioana.Andreica@elisabethgruppe.de.
  • Blazquez-Navarro A; Rheumazentrum Ruhrgebiet, Herne, Germany.
  • Sokolar J; Humboldt-Universität zu Berlin, Berlin Center for Advanced Therapies (BeCAT), Charite Universitätsmedizin, Berlin, Germany.
  • Anft M; Ruhr-Universität Bochum, Bochum, Germany.
  • Kiltz U; Rheumazentrum Ruhrgebiet, Herne, Germany.
  • Pfaender S; Center for Translational Medicine and Immune Diagnostics Laboratory, Medical department I, Marien Hospital, University Hospital of the Ruhr-Universität Bochum, Herne, Germany.
  • Vidal Blanco E; Ruhr-Universität Bochum, Bochum, Germany.
  • Westhoff T; Rheumazentrum Ruhrgebiet, Herne, Germany.
  • Babel N; Department of Molecular and Medical Virology, Ruhr-Universität, Bochum, Germany.
  • Stervbo U; Department of Molecular and Medical Virology, Ruhr-Universität, Bochum, Germany.
  • Baraliakos X; Ruhr-Universität Bochum, Bochum, Germany.
RMD Open ; 8(2)2022 09.
Article in English | MEDLINE | ID: covidwho-2029522
ABSTRACT

OBJECTIVES:

The effect of different modes of immunosuppressive therapy in autoimmune inflammatory rheumatic diseases (AIRDs) remains unclear. We investigated the impact of immunosuppressive therapies on humoral and cellular responses after two-dose vaccination.

METHODS:

Patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with TNFi, IL-17i (biological disease-modifying antirheumatic drugs, b-DMARDs), Janus-kinase inhibitors (JAKi) (targeted synthetic, ts-DMARD) or methotrexate (MTX) (conventional synthetic DMARD, csDMARD) alone or in combination were included. Almost all patients received mRNA-based vaccine, four patients had a heterologous scheme. Neutralising capacity and levels of IgG against SARS-CoV-2 spike-protein were evaluated together with quantification of activation markers on T-cells and their production of key cytokines 4 weeks after first and second vaccination.

RESULTS:

92 patients were included, median age 50 years, 50% female, 33.7% receiving TNFi, 26.1% IL-17i, 26.1% JAKi (all alone or in combination with MTX), 14.1% received MTX only. Although after first vaccination only 37.8% patients presented neutralising antibodies, the majority (94.5%) developed these after the second vaccination. Patients on IL17i developed the highest titres compared with the other modes of action. Co-administration of MTX led to lower, even if not significant, titres compared with b/tsDMARD monotherapy. Neutralising antibodies correlated well with IgG titres against SARS-CoV-2 spike-protein. T-cell immunity revealed similar frequencies of activated T-cells and cytokine profiles across therapies.

CONCLUSIONS:

Even after insufficient seroconversion for neutralising antibodies and IgG against SARS-CoV-2 spike-protein in patients with AIRDs on different medications, a second vaccination covered almost all patients regardless of DMARDs therapy, with better outcomes in those on IL-17i. However, no difference of bDMARD/tsDMARD or csDMARD therapy was found on the cellular immune response.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Antirheumatic Agents / Janus Kinase Inhibitors / COVID-19 Type of study: Experimental Studies Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: Rmdopen-2022-002293

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Rheumatoid / Antirheumatic Agents / Janus Kinase Inhibitors / COVID-19 Type of study: Experimental Studies Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: Rmdopen-2022-002293