TY - JOUR T1 - Type of vaccine and immunosuppressive therapy but not diagnosis critically influence antibody response after COVID-19 vaccination in patients with rheumatic disease JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2022-002650 VL - 8 IS - 2 SP - e002650 AU - Leonie Maria Frommert AU - Amanthi Nadira Arumahandi de Silva AU - Jan Zernicke AU - Veronika Scholz AU - Tanja Braun AU - Lara Maria Jeworowski AU - Tatjana Schwarz AU - Pinkus Tober-Lau AU - Alexander ten Hagen AU - Elisa Habermann AU - Florian Kurth AU - Leif Erik Sander AU - Victor Max Corman AU - Gerd-RĂ¼diger Burmester AU - Robert Biesen AU - Fredrik N. Albach AU - Jens Klotsche Y1 - 2022/12/01 UR - http://rmdopen.bmj.com/content/8/2/e002650.abstract N2 - Objective The development of sufficient COVID-19 vaccines has been a big breakthrough in fighting the global SARS-CoV-2 pandemic. However, vaccination effectiveness can be reduced in patients with autoimmune rheumatic diseases (AIRD). The aim of this study was to identify factors that lead to a diminished humoral vaccination response in patients with AIRD.Methods Vaccination response was measured with a surrogate virus neutralisation test and by testing for antibodies directed against the receptor-binding-domain (RBD) of SARS-CoV-2 in 308 fully vaccinated patients with AIRD. In addition, 296 immunocompetent participants were investigated as a control group. Statistical adjusted analysis included covariates with a possible influence on antibody response.Results Patients with AIRD showed lower antibody responses compared with immunocompetent individuals (median neutralising capacity 90.8% vs 96.5%, p<0.001; median anti-RBD-IgG 5.6 S/CO vs 6.7 S/CO, p<0.001). Lower antibody response was significantly influenced by type of immunosuppressive therapy, but not by rheumatic diagnosis, with patients under rituximab therapy developing the lowest antibody levels. Patients receiving mycophenolate, methotrexate or janus kinase inhibitors also showed reduced vaccination responses. Additional negative influencing factors were vaccination with AZD1222, old age and shorter intervals between the first two vaccinations.Conclusion Certain immunosuppressive therapies are associated with lower antibody responses after vaccination. Additional factors such as vaccine type, age and vaccination interval should be taken into account. We recommend antibody testing in at-risk patients with AIRD and emphasise the importance of booster vaccinations in these patients.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. ER -