Artikel
Impact of different classes of immune-suppressive treatments on the immune response before and after COVID booster vaccination
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Veröffentlicht: | 31. August 2022 |
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Gliederung
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Introduction: The 2019 coronavirus disease (COVID-19) has become one of the most consequential pandemics ever. Fortunately, effective vaccines have been developed. However, a prerequisite for adequate response after vaccination is a competent immune system, which may be influenced by diseases or therapies.
Methods: The goal of this project is to evaluate the vaccination response of patients with primary immunodeficiency or immune-mediated inflammatory diseases (IMIDs) treated with rituximab or abatacept (Group 1) and IMID patients with cs/bDMARDs treatment (Group 2). Patients were assessed before (baseline visit; BL) and 2 (visit 1), 4 (visit 2) and 8 (visit 3) weeks after booster vaccination. A sufficient immune response was defined if SARS-COV-2-spike-protein-antibodies (AB) ≥120 BAU/ml, surrogate-neutralizing test (sNT) ≥30%, and interferone-gamma-release assay (IGRA) >200 mIU/ml.
Results: 52 patients were included, of which 2 dropped out. 23 patients were in group 1 and 27 in group 2. Baseline characteristics are listed in Table 1 [Tab. 1]. At the time of this interims analysis, approx. 70% of each group reached at least V2 analysis.
No patient had a cured coronavirus disease measured by absence of SARS-COV-2-nucleocapsid-protein-antibodies at BL.
The following results were observed at BL and at V2 in group 1
- 52.2% (BL) and 50% (V2) of patients showed a significant amount of ABs
- sNTs were found in 21.7% (BL) and 62.5% (V2) of patients
- IGRA was positive in 60.9% (BL) and 68.8% (V2) of patients
and in group 2
- 40.7% (BL) and 84.2% (V2) of patients showed a significant amount of ABs
- sNTs were found in 74.1% (BL) and 89.5% (V2) of patients
- IGRA was positive in 63.0% (BL) and 73.7% (V2) of patients
Conclusion: The proportion of patients with positive AB levels in group 2 doubled 4 weeks after booster vaccination, while it remained unchanged in group 1. In group 1, the proportion of patients with positive sNTs was far smaller at BL compared to group 2, but almost tripled 4 weeks after booster vaccination, while in group 2 it only increased by 15%. IGRA showed comparable levels in both groups at both time points indicating a T-cell response also in group 1.
Disclosures: None declared.
Table 2 [Tab. 2]