PT - JOURNAL ARTICLE AU - Ulf M Geisen AU - Melike Sümbül AU - Florian Tran AU - Dennis K Berner AU - Hayley M Reid AU - Lena Vullriede AU - Maria Ciripoi AU - Ann C Longardt AU - Paula Hoff AU - Peter J Morrison AU - Verena E Schneider AU - Rainald Zeuner AU - Jan H Schirmer AU - Andrea Steinbach AU - Susanna Nikolaus AU - S Gerdes AU - Stefan Schreiber AU - Petra Bacher AU - Bimba F Hoyer TI - Humoral protection to SARS-CoV2 declines faster in patients on TNF alpha blocking therapies AID - 10.1136/rmdopen-2021-002008 DP - 2021 Dec 01 TA - RMD Open PG - e002008 VI - 7 IP - 3 4099 - http://rmdopen.bmj.com/content/7/3/e002008.short 4100 - http://rmdopen.bmj.com/content/7/3/e002008.full SO - RMD Open2021 Dec 01; 7 AB - Background The persistence of the SARS-CoV2 pandemic, partly due to the appearance of highly infectious variants, has made booster vaccinations necessary for vulnerable groups. Questions remain as to which cohorts require SARS-CoV2 boosters. However, there is a critical lack of data on the dynamics of vaccine responses in patients with chronic inflammatory diseases (CID) undergoing immunosuppressive/disease modifying anti-rheumatic (DMARD) treatment. Here, we present the first data regarding the decline of the vaccine-induced humoral immune responses in patients with CID.Methods 23 patients with CID were monitored clinically and for anti-spike IgG and IgA levels, neutralization efficacy and antigen-specific CD4+ T cell responses over the first 6 months after SARS-CoV2 vaccination. 24 healthy individuals were included as controls.Results While anti-spike IgG-levels declined in CID patients and healthy controls, patients receiving anti-TNF treatment showed significantly greater declines at 6 months post second vaccination in IgG and especially neutralizing antibodies. IgA levels were generally lower in CID patients, particularly during anti-TNF therapy. No differences in SARS-CoV2 spike-specific CD4+ T-cell frequencies were detected.Conclusion Although the long-term efficacy of SARS-CoV2 vaccination in CID patients undergoing disease-modifying therapy is still not known, the pronounced declines in humoral responses towards SARS-CoV2 6 months after mRNA vaccination in the context of TNF blockade should be considered when formulating booster regimens. These patients should be considered for early booster vaccinations.