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Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy
BACKGROUND: Patients with chronic kidney disease (CKD) or kidney replacement therapy demonstrate lower antibody levels after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination compared with healthy controls. In a prospective cohort, we analysed the impact of immunosuppressive t...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972832/ https://www.ncbi.nlm.nih.gov/pubmed/36865021 http://dx.doi.org/10.1093/ckj/sfac249 |
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author | Bouwmans, Pim Messchendorp, A Lianne Imhof, Céline Sanders, Jan-Stephan F Hilbrands, Luuk B Reinders, Marlies E J Vart, Priya Bemelman, Frederike J Abrahams, Alferso C van den Dorpel, René M A Ten Dam, Marc A G J de Vries, Aiko P J Rispens, Theo Steenhuis, Maurice Gansevoort, Ron T Hemmelder, Marc H |
author_facet | Bouwmans, Pim Messchendorp, A Lianne Imhof, Céline Sanders, Jan-Stephan F Hilbrands, Luuk B Reinders, Marlies E J Vart, Priya Bemelman, Frederike J Abrahams, Alferso C van den Dorpel, René M A Ten Dam, Marc A G J de Vries, Aiko P J Rispens, Theo Steenhuis, Maurice Gansevoort, Ron T Hemmelder, Marc H |
author_sort | Bouwmans, Pim |
collection | PubMed |
description | BACKGROUND: Patients with chronic kidney disease (CKD) or kidney replacement therapy demonstrate lower antibody levels after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination compared with healthy controls. In a prospective cohort, we analysed the impact of immunosuppressive treatment and type of vaccine on antibody levels after three SARS-CoV-2 vaccinations. METHODS: Control subjects (n = 186), patients with CKD G4/5 (n = 400), dialysis patients (n = 480) and kidney transplant recipients (KTR) (n = 2468) were vaccinated with either mRNA-1273 (Moderna), BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford/AstraZeneca) in the Dutch SARS-CoV-2 vaccination programme. Third vaccination data were available in a subgroup of patients (n = 1829). Blood samples and questionnaires were obtained 1 month after the second and third vaccination. Primary endpoint was the antibody level in relation to immunosuppressive treatment and type of vaccine. Secondary endpoint was occurrence of adverse events after vaccination. RESULTS: Antibody levels after two and three vaccinations were lower in patients with CKD G4/5 and dialysis patients with immunosuppressive treatment compared with patients without immunosuppressive treatment. After two vaccinations, we observed lower antibody levels in KTR using mycophenolate mofetil (MMF) compared with KTR not using MMF [20 binding antibody unit (BAU)/mL (3–113) vs 340 BAU/mL (50–1492), P < .001]. Seroconversion was observed in 35% of KTR using MMF, compared with 75% of KTR not using MMF. Of the KTR who used MMF and did not seroconvert, eventually 46% seroconverted after a third vaccination. mRNA-1273 induces higher antibody levels as well as a higher frequency of adverse events compared with BNT162b2 in all patient groups. CONCLUSIONS: Immunosuppressive treatment adversely affects the antibody levels after SARS-CoV-2 vaccination in patients with CKD G4/5, dialysis patients and KTR. mRNA-1273 vaccine induces a higher antibody level and higher frequency of adverse events. |
format | Online Article Text |
id | pubmed-9972832 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-99728322023-03-01 Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy Bouwmans, Pim Messchendorp, A Lianne Imhof, Céline Sanders, Jan-Stephan F Hilbrands, Luuk B Reinders, Marlies E J Vart, Priya Bemelman, Frederike J Abrahams, Alferso C van den Dorpel, René M A Ten Dam, Marc A G J de Vries, Aiko P J Rispens, Theo Steenhuis, Maurice Gansevoort, Ron T Hemmelder, Marc H Clin Kidney J Original Article BACKGROUND: Patients with chronic kidney disease (CKD) or kidney replacement therapy demonstrate lower antibody levels after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination compared with healthy controls. In a prospective cohort, we analysed the impact of immunosuppressive treatment and type of vaccine on antibody levels after three SARS-CoV-2 vaccinations. METHODS: Control subjects (n = 186), patients with CKD G4/5 (n = 400), dialysis patients (n = 480) and kidney transplant recipients (KTR) (n = 2468) were vaccinated with either mRNA-1273 (Moderna), BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford/AstraZeneca) in the Dutch SARS-CoV-2 vaccination programme. Third vaccination data were available in a subgroup of patients (n = 1829). Blood samples and questionnaires were obtained 1 month after the second and third vaccination. Primary endpoint was the antibody level in relation to immunosuppressive treatment and type of vaccine. Secondary endpoint was occurrence of adverse events after vaccination. RESULTS: Antibody levels after two and three vaccinations were lower in patients with CKD G4/5 and dialysis patients with immunosuppressive treatment compared with patients without immunosuppressive treatment. After two vaccinations, we observed lower antibody levels in KTR using mycophenolate mofetil (MMF) compared with KTR not using MMF [20 binding antibody unit (BAU)/mL (3–113) vs 340 BAU/mL (50–1492), P < .001]. Seroconversion was observed in 35% of KTR using MMF, compared with 75% of KTR not using MMF. Of the KTR who used MMF and did not seroconvert, eventually 46% seroconverted after a third vaccination. mRNA-1273 induces higher antibody levels as well as a higher frequency of adverse events compared with BNT162b2 in all patient groups. CONCLUSIONS: Immunosuppressive treatment adversely affects the antibody levels after SARS-CoV-2 vaccination in patients with CKD G4/5, dialysis patients and KTR. mRNA-1273 vaccine induces a higher antibody level and higher frequency of adverse events. Oxford University Press 2022-11-24 /pmc/articles/PMC9972832/ /pubmed/36865021 http://dx.doi.org/10.1093/ckj/sfac249 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Bouwmans, Pim Messchendorp, A Lianne Imhof, Céline Sanders, Jan-Stephan F Hilbrands, Luuk B Reinders, Marlies E J Vart, Priya Bemelman, Frederike J Abrahams, Alferso C van den Dorpel, René M A Ten Dam, Marc A G J de Vries, Aiko P J Rispens, Theo Steenhuis, Maurice Gansevoort, Ron T Hemmelder, Marc H Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title | Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title_full | Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title_fullStr | Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title_full_unstemmed | Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title_short | Impact of immunosuppressive treatment and type of SARS-CoV-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
title_sort | impact of immunosuppressive treatment and type of sars-cov-2 vaccine on antibody levels after three vaccinations in patients with chronic kidney disease or kidney replacement therapy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972832/ https://www.ncbi.nlm.nih.gov/pubmed/36865021 http://dx.doi.org/10.1093/ckj/sfac249 |
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