TY - JOUR T1 - Postvaccination anti-S IgG levels predict anti-SARS-CoV-2 neutralising activity over 24 weeks in patients with RA JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2022-002575 VL - 8 IS - 2 SP - e002575 AU - Kristin Schmiedeberg AU - Irene A Abela AU - Natalia Barbara Pikor AU - Nicolas Vuilleumier AU - Magdalena Schwarzmueller AU - Selina Epp AU - Sabrina Pagano AU - Sarah Grabherr AU - Angelica Brooke Patterson AU - Madalina Nussberger AU - Alexandra Trkola AU - Burkhard Ludewig AU - Johannes von Kempis AU - Andrea Rubbert-Roth Y1 - 2022/10/01 UR - http://rmdopen.bmj.com/content/8/2/e002575.abstract N2 - Objectives To correlate immune responses following a two-dose regimen of mRNA anti-SARS-CoV-2 vaccines in patients with rheumatoid arthritis (RA) to the development of a potent neutralising antiviral activity.Methods The RECOVER study was a prospective, monocentric study including patients with RA and healthy controls (HCs). Assessments were performed before, and 3, 6, 12 and 24 weeks, after the first vaccine dose, respectively, and included IgG, IgA and IgM responses (against receptor binding domain, S1, S2, N), IFN-γ ELISpots as well as neutralisation assays.Results In patients with RA, IgG responses developed slower with lower peak titres compared with HC. Potent neutralising activity assessed by a SARS-CoV-2 pseudovirus neutralisation assay after 12 weeks was observed in all 21 HCs, and in 60.3% of 73 patients with RA. A significant correlation between peak anti-S IgG levels 2 weeks after the second vaccine dose and potent neutralising activity against SARS-CoV-2 was observed at weeks 12 and 24. The analysis of IgG, IgA and IgM isotype responses to different viral proteins demonstrated a delay in IgG but not in IgA and IgM responses. T cell responses were comparable in HC and patients with RA but declined earlier in patients with RA.Conclusion In patients with RA, vaccine-induced IgG antibody levels were diminished, while IgA and IgM responses persisted, indicating a delayed isotype switch. Anti-S IgG levels 2 weeks after the second vaccine dose correlate with the development of a potent neutralising activity after 12 and 24 weeks and may allow to identify patients who might benefit from additional vaccine doses or prophylactic regimen.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. ER -