Détail du document
Identifiant
oai:pubmedcentral.nih.gov:1043...
Sujet
ResearchAuteur
Plasencia-Rodríguez, Chamaida Martínez-Feito, Ana Hernández, Marta Del Pino-Molina, Lucia Novella-Navarro, Marta Serrano, Yolanda González-Muñoz, Miguel Peiteado, Diana Bonilla, Gema Monjo, Irene Nuño, Laura Tornero, Carolina López-Granados, Eduardo Balsa, Alejandro Nozal, PilarLangue
enEditeur
BioMed Central
Catégorie
Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
Année
2023
Date de référencement
22/09/2023
Mots clés
lower humoral treated rituximab controls response sars-cov-2 ab vaccination levels tnfi imids patientsRésumé
BACKGROUND: Real world data on the response to the SARS-CoV-2 vaccine in patients with immunomediated diseases (IMIDs) treated with immunesuppressants is of great interest because vaccine response may be impaired.
The main aim was to study the humoral and cellular immune response after SARS-CoV-2 vaccination in patients with IMIDs treated with immunosuppressants.
The secondary aim was to describe the frequency of SARS-CoV-2 infections after vaccination in these patients.
MATERIAL AND METHODS: This is an observational study including 86 patients with IMIDs.
All patients were treated with biologic or targeted synthetic disease-modifying antirheumatic drugs [b/tsDMARDs: TNF inhibitors (TNFi), rituximab, anti-interleukin 6 receptor (anti-IL6R) or JAK inhibitors (JAKi)].
Demographic and clinical information were collected.
After 4–6 weeks of 2nd and 3rd vaccine doses, humoral response was assessed using the Thermo Scientific ELiA SARS-CoV-2-Sp1 IgG Test.
Also, in patients with serum SARS-CoV-2 antibody levels under 100UI/ml, cellular response was analyzed using the QuantiFERON SARS-CoV-2 Starter Pack.
RESULTS: A total of 86 patients under b/tsDMARDs and 38 healthy controls were included.
Most patients received TNFi (45 with TNFi, 31 with rituximab, 5 with anti-IL6R and 5 with JAKi).
SARS-CoV-2 antibodies (Ab) were present in an 86% of patients with IMIDs and in 100% healthy controls (p = 0.017).
However, 12 (14%) patients had undetectable SARS-CoV-2 Ab levels, all treated with rituximab.
In addition, SARS-CoV-2 Ab (IU/ml) were statistically lower in patients (Mdn (IQR): 59.5 (17–163) in patients vs 625 (405–932) in controls, p < 0.001).
Patients treated with rituximab had lower Ab levels than those treated with TNFi and controls (p < 0.001).
The cellular response to SARS-CoV-2 vaccine was evaluated in 30 patients.
Eleven patients had a positive cellular response, being more frequent in patients treated with rituximab (p = 0.03).
SARS-CoV-2 infection was reported in 43% of patients and 34% of controls after vaccination.
Only 6 (7%) patients required hospitalization, most of whom treated with rituximab (67%).
CONCLUSION: SARS-CoV-2 antibody levels were lower in patients than in controls, especially in patients treated with rituximab.
A cellular response can be detected despite having a poor humoral response.
Severe infections in vaccinated patients with IMIDs are rare, and are observed mainly in patients treated with rituximab.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13223-023-00832-0.
Plasencia-Rodríguez, Chamaida,Martínez-Feito, Ana,Hernández, Marta,Del Pino-Molina, Lucia,Novella-Navarro, Marta,Serrano, Yolanda,González-Muñoz, Miguel,Peiteado, Diana,Bonilla, Gema,Monjo, Irene,Nuño, Laura,Tornero, Carolina,López-Granados, Eduardo,Balsa, Alejandro,Nozal, Pilar, 2023, Immune response after SARS-CoV-2 vaccination in patients with inflammatory immune-mediated diseases receiving immunosuppressive treatment, BioMed Central
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