Ioana Andreica, Arturo Blazquez-Navarro, Jan Sokolar, Moritz Anft, Uta Kiltz, Stephanie Pfänder, Elena Vidal Blanco, Timm Westhoff, Nina Babel, Ulrik Stervbo-Kristensen, Xenofon Baraliakos
- \(\bf Objectives\)
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.
\(\bf Methods\)
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.
\(\bf Results\)
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.
\(\bf Conclusions\)
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.
MetadatenAuthor: | Ioana AndreicaORCiDGND, Arturo Blazquez-NavarroGND, Jan SokolarGND, Moritz AnftGND, Uta KiltzORCiDGND, Stephanie PfänderORCiDGND, Elena Vidal BlancoGND, Timm WesthoffORCiDGND, Nina BabelORCiDGND, Ulrik Stervbo-KristensenORCiDGND, Xenofon BaraliakosORCiDGND |
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URN: | urn:nbn:de:hbz:294-103589 |
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DOI: | https://doi.org/10.1136/rmdopen-2022-002293 |
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Parent Title (English): | RMD Open |
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Publisher: | BMJ Publishing Group |
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Place of publication: | London, Vereinigtes Königreich |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2023/11/10 |
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Date of first Publication: | 2022/09/14 |
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Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
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Tag: | Open Access Fonds |
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Volume: | 8 |
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Issue: | 2, Article e002293 |
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First Page: | e002293-1 |
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Last Page: | e002293-11 |
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Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
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Institutes/Facilities: | Rheumazentrum Ruhrgebiet |
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Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
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open_access (DINI-Set): | open_access |
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Licence (English): | Creative Commons - CC BY-NC 4.0 - Attribution-NonCommercial 4.0 International |
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