RT Journal Article
SR Electronic
T1 Humoral protection to SARS-CoV2 declines faster in patients on TNF alpha blocking therapies
JF RMD Open
JO RMD Open
FD EULAR
SP e002008
DO 10.1136/rmdopen-2021-002008
VO 7
IS 3
A1 Geisen, Ulf M
A1 Sümbül, Melike
A1 Tran, Florian
A1 Berner, Dennis K
A1 Reid, Hayley M
A1 Vullriede, Lena
A1 Ciripoi, Maria
A1 Longardt, Ann C
A1 Hoff, Paula
A1 Morrison, Peter J
A1 Schneider, Verena E
A1 Zeuner, Rainald
A1 Schirmer, Jan H
A1 Steinbach, Andrea
A1 Nikolaus, Susanna
A1 Gerdes, S
A1 Schreiber, Stefan
A1 Bacher, Petra
A1 Hoyer, Bimba F
YR 2021
UL http://rmdopen.bmj.com/content/7/3/e002008.abstract
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.