gms | German Medical Science

Deutscher Rheumatologiekongress 2022, 50. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 36. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 32. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

31.08. - 03.09.2022, Berlin

Comparison of disease-modifying anti-rheumatic drugs in inducing immunogenicity to SARS-CoV2 vaccines in adult patients with autoimmune musculoskeletal inflammatory rheumatic diseases

Meeting Abstract

  • Ioana Andreica - Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
  • Arturo Blazquez-Navarro - Berlin Center for Advanced Therapies, Charite Universitätsmedizin, Berlin
  • Jan Sokolar - Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
  • Moritz Anft - Ruhr-Universität Bochum, Bochum; Marien Hospital Herne, Herne
  • Uta Kiltz - Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
  • Stephanie Pfaender - Ruhr-Universität Bochum, Bochum
  • Elena Vidal Blanco - Ruhr-Universität Bochum, Bochum
  • Timm Westhoff - Ruhr-Universität Bochum, Bochum; Marien Hospital Herne, Herne
  • Nina Babel - Berlin Center for Advanced Therapies, Charite Universitätsmedizin, Berlin; Marien Hospital Herne, Herne
  • Ulrik Stervbo - Ruhr-Universität Bochum, Bochum; Marien Hospital Herne, Herne
  • Xenofon Baraliakos - Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2022, 50. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 36. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 32. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Berlin, 31.08.-03.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocCO.11

doi: 10.3205/22dgrh010, urn:nbn:de:0183-22dgrh0101

Veröffentlicht: 31. August 2022

© 2022 Andreica et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Introduction: The interplay between humoral and cellular response after vaccination against COVID-19 infection in patients with autoimmune inflammatory rheumatic diseases (AIRD) remains unknown. We investigated the impact of 4 different immunosuppressive therapies in AIRD patients under stable low disease activity status on the development of humoral and cellular immune responses to full 2-dose SARS-CoV-2 vaccination.

Methods: Patients with rheumatoid arthritis, axial spondyloarthritis or psoriasis arthritis treated with tumor necrosis factor inhibitors (TNFi), interleukin (IL)-17i (biologics-), janus kinase inhibitors (JAKi) (targeted synthetic-), or methotrexate (MTX) (conventional synthetic- disease modifying antirheumatic drugs (csDMARD)) alone or in combination were included. Almost all patients received mRNA-based vaccine, 4 patients had a heterologous scheme. Neutralizing capacity (NC) against SARS-CoV-2 wild variant and levels of IgG against SARS-CoV-2 spike-protein were evaluated together with quantification of activation markers on T-cells and their production of key cytokines 4 weeks after first and second vaccination.

Results: Overall, a total of 92 patients were included in the final study cohort with the median age of 50 years [IRQ: 39-56] and a 50% female ratio. 33.7% patients were on TNFi, 26.1% on IL-17i, 26.1% on JAKi, each group encompassing patients receiving drug inhibitors alone or in combination with MTX. 14.1% were treated with MTX alone. Although after first vaccination only 37.8% patients presented neutralizing antibodies, the majority (94.5%) showed neutralizing antibodies after second vaccination. Spike-protein specific IgG antibodies were found in 98.9% of all patients. Patients on IL17i developed the highest titers compared to the other modes of action. Co-administration of MTX led to lower titers compared to b/tsDMARD monotherapy. NC correlated well with IgG against SARS-CoV-2 spike-protein titers. T-cell immunity revealed similar frequencies of activated T-cells and cytokine profiles across therapies.

Conclusion: Even after insufficient seroconversion for NC and IgG against SARS-CoV-2 spike-proteins in AIRD patients between different modes of action, a second vaccination covered almost all patients regardless of DMARDs therapy, with better outcomes in those on IL-17i. However, no difference of b-/ts- or cs-DMARD therapy was found on the cellular immune response.

Figure 1 [Fig. 1], Figure 2 [Fig. 2]