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The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination

OBJECTIVES: This study aimed to assess the duration of humoral responses after two doses of SARS-CoV-2 mRNA vaccines in patients with inflammatory joint diseases and IBD and booster vaccination compared with healthy controls. It also aimed to analyze factors influencing the quantity and quality of t...

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Autores principales: Tobudic, Selma, Simader, Elisabeth, Deimel, Thomas, Straub, Jennifer, Kartnig, Felix, Heinz, Leonhard X., Mandl, Peter, Haslacher, Helmuth, Perkmann, Thomas, Schneider, Lisa, Nothnagl, Thomas, Radner, Helga, Winkler, Florian, Burgmann, Heinz, Stiasny, Karin, Novacek, Gottfried, Reinisch, Walter, Aletaha, Daniel, Winkler, Stefan, Blüml, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947701/
https://www.ncbi.nlm.nih.gov/pubmed/36844197
http://dx.doi.org/10.3389/fmed.2023.1049157
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author Tobudic, Selma
Simader, Elisabeth
Deimel, Thomas
Straub, Jennifer
Kartnig, Felix
Heinz, Leonhard X.
Mandl, Peter
Haslacher, Helmuth
Perkmann, Thomas
Schneider, Lisa
Nothnagl, Thomas
Radner, Helga
Winkler, Florian
Burgmann, Heinz
Stiasny, Karin
Novacek, Gottfried
Reinisch, Walter
Aletaha, Daniel
Winkler, Stefan
Blüml, Stephan
author_facet Tobudic, Selma
Simader, Elisabeth
Deimel, Thomas
Straub, Jennifer
Kartnig, Felix
Heinz, Leonhard X.
Mandl, Peter
Haslacher, Helmuth
Perkmann, Thomas
Schneider, Lisa
Nothnagl, Thomas
Radner, Helga
Winkler, Florian
Burgmann, Heinz
Stiasny, Karin
Novacek, Gottfried
Reinisch, Walter
Aletaha, Daniel
Winkler, Stefan
Blüml, Stephan
author_sort Tobudic, Selma
collection PubMed
description OBJECTIVES: This study aimed to assess the duration of humoral responses after two doses of SARS-CoV-2 mRNA vaccines in patients with inflammatory joint diseases and IBD and booster vaccination compared with healthy controls. It also aimed to analyze factors influencing the quantity and quality of the immune response. METHODS: We enrolled 41 patients with rheumatoid arthritis (RA), 35 with seronegative spondyloarthritis (SpA), and 41 suffering from inflammatory bowel disease (IBD), excluding those receiving B-cell-depleting therapies. We assessed total anti-SARS-CoV-2 spike antibodies (Abs) and neutralizing Ab titers 6 months after two and then after three doses of mRNA vaccines compared with healthy controls. We analyzed the influence of therapies on the humoral response. RESULTS: Patients receiving biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) showed reduced anti-SARS-CoV-2 S Abs and neutralizing Ab titers compared with HC or patients receiving conventional synthetic (cs)DMARDs 6 months after the first two vaccination doses. Anti-SARS-CoV-2 S titers of patients with b/tsDMARDs declined more rapidly, leading to a significant reduction in the duration of vaccination-induced immunity after two doses of SARS-CoV-2 mRNA vaccines. While 23% of HC and 19% of patients receiving csDMARDs were without detectable neutralizing Abs 6 months after the first two vaccination doses, this number was 62% in patients receiving b/tsDMARDs and 52% in patients receiving a combination of csDMARDs and b/tsDMARDs. Booster vaccination led to increased anti-SARS-CoV-2 S Abs in all HC and patients. However, anti-SARS-CoV-2 S Abs after booster vaccination was diminished in patients receiving b/tsDMARDs, either alone or in combination with csDMARDs compared to HC. CONCLUSION: Patients receiving b/tsDMARDs have significantly reduced Abs and neutralizing Ab titers 6 months after mRNA vaccination against SARS-CoV-2. This was due to a faster decline in Ab levels, indicating a significantly reduced duration of vaccination-induced immunity compared with HC or patients receiving csDMARDs. In addition, they display a reduced response to a booster vaccination, warranting earlier booster vaccination strategies in patients under b/tsDMARD therapy, according to their specific Ab levels.
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spelling pubmed-99477012023-02-24 The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination Tobudic, Selma Simader, Elisabeth Deimel, Thomas Straub, Jennifer Kartnig, Felix Heinz, Leonhard X. Mandl, Peter Haslacher, Helmuth Perkmann, Thomas Schneider, Lisa Nothnagl, Thomas Radner, Helga Winkler, Florian Burgmann, Heinz Stiasny, Karin Novacek, Gottfried Reinisch, Walter Aletaha, Daniel Winkler, Stefan Blüml, Stephan Front Med (Lausanne) Medicine OBJECTIVES: This study aimed to assess the duration of humoral responses after two doses of SARS-CoV-2 mRNA vaccines in patients with inflammatory joint diseases and IBD and booster vaccination compared with healthy controls. It also aimed to analyze factors influencing the quantity and quality of the immune response. METHODS: We enrolled 41 patients with rheumatoid arthritis (RA), 35 with seronegative spondyloarthritis (SpA), and 41 suffering from inflammatory bowel disease (IBD), excluding those receiving B-cell-depleting therapies. We assessed total anti-SARS-CoV-2 spike antibodies (Abs) and neutralizing Ab titers 6 months after two and then after three doses of mRNA vaccines compared with healthy controls. We analyzed the influence of therapies on the humoral response. RESULTS: Patients receiving biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) showed reduced anti-SARS-CoV-2 S Abs and neutralizing Ab titers compared with HC or patients receiving conventional synthetic (cs)DMARDs 6 months after the first two vaccination doses. Anti-SARS-CoV-2 S titers of patients with b/tsDMARDs declined more rapidly, leading to a significant reduction in the duration of vaccination-induced immunity after two doses of SARS-CoV-2 mRNA vaccines. While 23% of HC and 19% of patients receiving csDMARDs were without detectable neutralizing Abs 6 months after the first two vaccination doses, this number was 62% in patients receiving b/tsDMARDs and 52% in patients receiving a combination of csDMARDs and b/tsDMARDs. Booster vaccination led to increased anti-SARS-CoV-2 S Abs in all HC and patients. However, anti-SARS-CoV-2 S Abs after booster vaccination was diminished in patients receiving b/tsDMARDs, either alone or in combination with csDMARDs compared to HC. CONCLUSION: Patients receiving b/tsDMARDs have significantly reduced Abs and neutralizing Ab titers 6 months after mRNA vaccination against SARS-CoV-2. This was due to a faster decline in Ab levels, indicating a significantly reduced duration of vaccination-induced immunity compared with HC or patients receiving csDMARDs. In addition, they display a reduced response to a booster vaccination, warranting earlier booster vaccination strategies in patients under b/tsDMARD therapy, according to their specific Ab levels. Frontiers Media S.A. 2023-02-09 /pmc/articles/PMC9947701/ /pubmed/36844197 http://dx.doi.org/10.3389/fmed.2023.1049157 Text en Copyright © 2023 Tobudic, Simader, Deimel, Straub, Kartnig, Heinz, Mandl, Haslacher, Perkmann, Schneider, Nothnagl, Radner, Winkler, Burgmann, Stiasny, Novacek, Reinisch, Aletaha, Winkler and Blüml. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Tobudic, Selma
Simader, Elisabeth
Deimel, Thomas
Straub, Jennifer
Kartnig, Felix
Heinz, Leonhard X.
Mandl, Peter
Haslacher, Helmuth
Perkmann, Thomas
Schneider, Lisa
Nothnagl, Thomas
Radner, Helga
Winkler, Florian
Burgmann, Heinz
Stiasny, Karin
Novacek, Gottfried
Reinisch, Walter
Aletaha, Daniel
Winkler, Stefan
Blüml, Stephan
The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title_full The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title_fullStr The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title_full_unstemmed The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title_short The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
title_sort accelerated waning of immunity and reduced effect of booster in patients treated with bdmard and tsdmard after sars-cov-2 mrna vaccination
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947701/
https://www.ncbi.nlm.nih.gov/pubmed/36844197
http://dx.doi.org/10.3389/fmed.2023.1049157
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