期刊
ANNALS OF THE RHEUMATIC DISEASES
卷 81, 期 7, 页码 1023-1027出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/annrheumdis-2021-221554
关键词
antirheumatic agents; biological therapy; COVID-19
类别
资金
- Deutsche Forschungsgemeinschaft [DFG-FOR2886 PANDORA, CRC1181]
- Bundesministerium fur Bildung und Forschung (BMBF
- project MASCARA)
- ERC Synergy grant 4D Nanoscope
- IMI
- Emerging Fields Initiative MIRACLE of the Friedrich-Alexander-Universitat Erlangen-Nurnberg
- Else Kroner-Memorial Scholarship [2019_EKMS.27]
- Hector foundation [M2102]
The study found that a third vaccination in IMID patients who did not respond to standard vaccination can induce protective immunity. Seroconversion and neutralising activity were higher in non-RTX patients compared to RTX-treated patients. T cell responses did not significantly impact vaccination efficacy.
Objectives To test whether patients with immune-mediated inflammatory disease (IMIDs), who did not respond to two doses of the SARS-CoV-2 vaccine, develop protective immunity, if a third vaccine dose is administered. Methods Patients with IMID who failed to seroconvert after two doses of SARS-CoV-2 vaccine were subjected to a third vaccination with either mRNA or vector-based vaccines. Anti-SARS-CoV-2 IgG, neutralising activity and T cell responses were assessed at baseline and 3 weeks after revaccination and also evaluated seprarately in rituximab (RTX) and non-RTX exposed patients. Results 66 non-responders were recruited, 33 treated with RTX, and 33 non-exposed to RTX. Overall, 49.2% patients seroconverted and 50.0% developed neutralising antibody activity. Seroconversion (78.8% vs 18.2%) and neutralising activity (80.0% vs 21.9%) was higher in non-RTX than RTX-treated patients with IMID, respectively. Humoral vaccination responses were not different among patients showing positive (59.3%) or negative (49.7%) T cell responses at baseline. Patients remaining on mRNA-based vaccines showed similar vaccination responses compared with those switching to vector-based vaccines. Conclusions Overall, these data strongly argue in favor of a third vaccination in patients with IMID lacking response to standard vaccination irrespective of their B cell status.
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