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The impact of immun...
The impact of immunomodulating treatment on the immunogenicity of COVID-19 vaccines in patients with immune-mediated inflammatory rheumatic diseases compared to healthy controls. : A Swedish nationwide study (COVID19-REUMA)
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- Frodlund, Martina (author)
- Linköpings universitet,Linköping University,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Reumatologiska kliniken i Östergötland
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- Nived, Per (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Central Hospital Kristianstad,Lund Univ, Sweden; Skane Univ Hosp, Sweden
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- Chatzidionysiou, Aikaterini (author)
- Karolinska Institutet,Karolinska Univ Hosp, Sweden
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- Södergren, Anna, 1977- (author)
- Umeå University,Umeå universitet,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM),Reumatologi,Umed Univ, Dept Publ Hlth & Clin Med Rheumatol, Umed, Sweden.;Umed Univ, Wallenberg Ctr Mol Med WCMM, Umed, Sweden.
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- Klingberg, Eva (author)
- Gothenburg University,Göteborgs universitet,University of Gothenburg,Univ Gothenburg, Sweden,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research
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- Bengtsson, Anders (author)
- Lund University,Lunds universitet,Lund SLE Research Group,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden
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- Hansson, Monika (author)
- Karolinska Institutet,Karolinska Univ Hosp, Sweden
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- Olsson, Sophie (author)
- Lund University,Lunds universitet,Autoimmunitet och njursjukdomar,Forskargrupper vid Lunds universitet,Autoimmunity and kidney diseases,Lund University Research Groups,Skåne University Hospital,Skane Univ Hosp, Sweden; Lund Univ, Sweden
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- Pin, Elisa (author)
- KTH Royal Institute of Technology,KTH,Science for Life Laboratory, SciLifeLab,Proteinvetenskap,Department of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden,KTH Royal Inst Technol, Sweden
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- Klareskog, Lars (author)
- Karolinska Univ Hosp, Karolinska Inst, Dept Med, Div Rheumatol, Stockholm, Sweden.,Department of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital at Karolinska Institutet, Stockholm, Sweden
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- Kapetanovic, Meliha C (author)
- Lund University,Lunds universitet,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden
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(creator_code:org_t)
- Elsevier BV, 2023
- 2023
- English.
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In: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 41:20, s. 3247-3257
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Abstract
Subject headings
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- Objectives: To elucidate antibody responses after the second and third dose of COVID-19 vaccine in patients with inflammatory rheumatic diseases (IRD) treated with biologic/targeted disease modifying anti-rheumatic drugs (b/ts DMARDs).Methods: Antibody levels to antigens representing spike full length protein and spike S1 were measured before vaccination, 2-12 weeks after the second dose, before and after the third dose using multiplex bead-based serology assay. Positive antibody response was defined as antibody levels over cut off (seropositivity) in seronegative individuals or >= 4-fold increase in antibodies in individuals seropositive for both spike proteins.Results: Patients (n = 414) receiving b/ts DMARDs (283 had arthritis, 75 systemic vasculitis and 56 other autoimmune diseases) and controls (n = 61) from five Swedish regions participated. Treatments groups were: rituximab (n = 145); abatacept (n = 22); Interleukin 6 receptor inhibitors [IL6i (n = 79)]; JAnus Kinase Inhibitors [JAKi (n = 58)], Tumour Necrosis Factor inhibitor [TNFi (n = 68)] and Interleukin12/23/17 inhibitors [IL12/23/17i (n = 42)]. Percentage of patients with positive antibody response after two doses was significantly lower in rituximab (33,8%) and abatacept (40,9%) (p < 0,001) but not in IL12/23/17i, TNFi or JAKi groups compared to controls (80,3%). Higher age, ritux-imab treatment and shorter time between last rituximab course and vaccination predicted impaired anti-body response. Antibody levels collected 21-40 weeks after second dose decreased significantly (IL6i: p = 0,02; other groups: p < 0,001) compared to levels at 2-12 week but most participants remained seropositive. Proportion of patients with positive antibody response increased after third dose but was still significantly lower in rituximab (p < 0,001).Conclusions: Older individuals and patients on maintenance rituximab have an impaired response after two doses of COVID-19 vaccine which improves if the time between last rituximab course and vaccina-tion extends and also after an additional vaccine dose. Rituximab patients should be prioritized for (2023) booster vaccine doses. TNFi, JAKi and IL12/23/17i does not diminished humoral response to primary and an additional vaccination.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
Keyword
- COVID-19 vaccine
- Antibody response
- Immunogenicity
- Inflammatory rheumatic disease
- Rituximab
- Abatacept
- Methotrexate
- COVID-19 vaccine
- Antibody response
- Immunogenicity
- Inflammatory
- rheumatic disease
- Rituximab
- Abatacept
- Methotrexate
Publication and Content Type
- ref (subject category)
- art (subject category)
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Frodlund, Martin ...
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Nived, Per
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Chatzidionysiou, ...
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Södergren, Anna, ...
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Klingberg, Eva
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Bengtsson, Ander ...
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Hansson, Monika
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Olsson, Sophie
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Pin, Elisa
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Klareskog, Lars
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Kapetanovic, Mel ...
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Vaccine
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Royal Institute of Technology
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Umeå University
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Lund University
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Karolinska Institutet
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Linköping University
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University of Gothenburg