Serological Response to BNT162b2 Anti-SARS-CoV-2 Vaccination in Patients with Inflammatory Rheumatic Diseases: Results From the RHEUVAX Cohort.

Abstract

Objective:

In the light of the current COVID-19 epidemic and the availability of effective vaccines, this study aims to identify factors associated with non-response to anti-SARS-CoV-2 vaccines as immunological alteration associated with immune rheumatic diseases (IRD) and immunosuppressive medications may impair the response to vaccination.

Methods:

Volunteers in the health profession community with IRD, age, and sex-matched controls (CTRL) who underwent vaccination with two doses of BNT162b2 were recruited for this study. Anti-Trimeric Spike protein antibodies were assayed eight ± one weeks after the second vaccine dose. Univariate and logistic regression analyses were performed to identify factors independently associated with non-response and low antibody titers.

Results:

Samples were obtained from 237 IRD patients (m/f 73/164, mean age 57, CI 95% [56-59]): 4 autoinflammatory diseases (AI), 62 connective tissue diseases (CTD), 86 rheumatoid arthritis (RA), 71 spondylarthritis (SpA) and 14 vasculitis (Vsc). 232 CTRL were recruited (m/f 71/161, mean age 57, CI 95% [56-58]). Globally, IRD had a lower seroconversion rate (88.6% vs 99.6%, CI 95% OR [1.61-5.73], p<0.001) and lower antibody titer compared to controls (median (IQR) 403 (131.5-1012) versus 1160 (702.5-1675), p<0.001). After logistic regression, age, corticosteroid (CCS), Abatacept and Mycophenolate Mofetil (MMF) use were associated with non-response. Lower antibody titer was associated with the use of MMF, ABA, CCS, Rituximab, tumor necrosis factor inhibitor, JAK inhibitors, and higher age.

Conclusion:

The response to anti-SARS-CoV-2 vaccines is often impaired in IRD patients under treatment and may pose them at higher risk of severe COVID-19. Specific vaccination protocols are desirable for these patients.

• Authors: Daniele Mauro, Antonio Ciancio, Claudio Di Vico, Luana Passariello, Gelsomina Rozza, Maria Dora Pasquale, Ilenia Pantano, Carlo Cannistrà, Laura Bucci, Silvia Scriffignano, Flavia Riccio, Martina Patrone, Giuseppe Scalise, Piero Ruscitti, Maria Vittoria Montemurro, Antonio Giordano, Maria Teresa Vietri, Francesco Ciccia
• Journal: Frontiers in immunology (Front Immunol) Vol. 13 Pg. 901055 ( 2022) ISSN: 1664-3224 [Electronic] Switzerland
• PMID: 35784360 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Mauro, Ciancio, Di Vico, Passariello, Rozza, Pasquale, Pantano, Cannistrà, Bucci, Scriffignano, Riccio, Patrone, Scalise, Ruscitti, Montemurro, Giordano, Vietri and Ciccia.

Chemical References

• Antibodies, Viral
• Vaccines
• BNT162 Vaccine

Topics

• Antibodies, Viral
• Arthritis, Rheumatoid
• BNT162 Vaccine
• COVID-19 (prevention & control)
• Humans
• Middle Aged
• Severe acute respiratory syndrome-related coronavirus
• Vaccination
• Vaccines (pharmacology)