tetano
Editor, Senior Moderator
Rheumatol Adv Pract
. 2023 Nov 11;7(3):rkad097.
doi: 10.1093/rap/rkad097. eCollection 2023. Antibody response to four doses of SARS-CoV-2 vaccine in rare autoimmune rheumatic diseases: an observational study
Leher Gumber[SUP] 1 2 [/SUP], Hannah Jackson[SUP] 3 [/SUP], Nancy Gomez[SUP] 3 [/SUP], Georgina Hopkins[SUP] 3 [/SUP], Davis Tucis[SUP] 3 [/SUP], Mithun Chakravorty[SUP] 1 [/SUP], Patrick Tighe[SUP] 3 [/SUP], Matthew J Grainge[SUP] 2 [/SUP], Megan Rutter[SUP] 1 2 [/SUP], Alastair Ferraro[SUP] 4 [/SUP], Sheila Power[SUP] 5 [/SUP], Marie-Josèphe Pradère[SUP] 5 [/SUP], Peter C Lanyon[SUP] 1 2 6 [/SUP], Fiona A Pearce[SUP] 1 2 6 [/SUP], Lucy Fairclough[SUP] 3 [/SUP]
Affiliations
Objective: Antibody responses to coronavirus disease 2019 (COVID-19) vaccines are reduced among immunocompromised patients but are not well quantified among people with rare disease. We conducted an observational study to evaluate the antibody responses to the booster SARS-CoV-2 vaccine in people with rare autoimmune rheumatic diseases (RAIRD).
Methods: Blood samples were collected after second, before third, after third and after fourth vaccine doses. Anti-spike and anti-nucleocapsid antibody levels were measured using an in-house ELISA. Logistic regression models were built to determine the predictors for non-response. Results were compared with age- and sex-matched healthy controls.
Results: Forty-three people with RAIRD were included, with a median age of 56 years. Anti-spike seropositivity increased from 42.9% after second dose to 51.2% after third dose and 65.6% after fourth dose. Median anti-spike antibody levels increased from 33.6 (interquartile range 7.8-724.5) binding antibody units after second dose to 239.4 (interquartile range 35.8-1051.1) binding antibody units after the booster dose (third dose, or fourth dose if eligible). Of the participants who had sufficient antibody levels post-second dose, 22.2% had insufficient levels after the booster, and 34.9% of participants had lower antibodies after the booster than the lowest healthy control had after the second dose. Rituximab in the 6 months prior to booster (P = 0.02) and non-White ethnicity (P = 0.04) were associated with non-response. There was a dose-response relationship between the timing of rituximab and generation of sufficient antibodies (P = 0.03).
Conclusion: Although the booster dose increased anti-spike IgG and seropositivity rates, some people with RAIRD, particularly those on rituximab, had insufficient antibody levels despite three or four doses.
Keywords: SARS-CoV-2; antibody; rare autoimmune rheumatic diseases; rituximab; vaccination.
. 2023 Nov 11;7(3):rkad097.
doi: 10.1093/rap/rkad097. eCollection 2023. Antibody response to four doses of SARS-CoV-2 vaccine in rare autoimmune rheumatic diseases: an observational study
Leher Gumber[SUP] 1 2 [/SUP], Hannah Jackson[SUP] 3 [/SUP], Nancy Gomez[SUP] 3 [/SUP], Georgina Hopkins[SUP] 3 [/SUP], Davis Tucis[SUP] 3 [/SUP], Mithun Chakravorty[SUP] 1 [/SUP], Patrick Tighe[SUP] 3 [/SUP], Matthew J Grainge[SUP] 2 [/SUP], Megan Rutter[SUP] 1 2 [/SUP], Alastair Ferraro[SUP] 4 [/SUP], Sheila Power[SUP] 5 [/SUP], Marie-Josèphe Pradère[SUP] 5 [/SUP], Peter C Lanyon[SUP] 1 2 6 [/SUP], Fiona A Pearce[SUP] 1 2 6 [/SUP], Lucy Fairclough[SUP] 3 [/SUP]
Affiliations
- PMID: 38515961
- PMCID: PMC10956718
- DOI: 10.1093/rap/rkad097
Objective: Antibody responses to coronavirus disease 2019 (COVID-19) vaccines are reduced among immunocompromised patients but are not well quantified among people with rare disease. We conducted an observational study to evaluate the antibody responses to the booster SARS-CoV-2 vaccine in people with rare autoimmune rheumatic diseases (RAIRD).
Methods: Blood samples were collected after second, before third, after third and after fourth vaccine doses. Anti-spike and anti-nucleocapsid antibody levels were measured using an in-house ELISA. Logistic regression models were built to determine the predictors for non-response. Results were compared with age- and sex-matched healthy controls.
Results: Forty-three people with RAIRD were included, with a median age of 56 years. Anti-spike seropositivity increased from 42.9% after second dose to 51.2% after third dose and 65.6% after fourth dose. Median anti-spike antibody levels increased from 33.6 (interquartile range 7.8-724.5) binding antibody units after second dose to 239.4 (interquartile range 35.8-1051.1) binding antibody units after the booster dose (third dose, or fourth dose if eligible). Of the participants who had sufficient antibody levels post-second dose, 22.2% had insufficient levels after the booster, and 34.9% of participants had lower antibodies after the booster than the lowest healthy control had after the second dose. Rituximab in the 6 months prior to booster (P = 0.02) and non-White ethnicity (P = 0.04) were associated with non-response. There was a dose-response relationship between the timing of rituximab and generation of sufficient antibodies (P = 0.03).
Conclusion: Although the booster dose increased anti-spike IgG and seropositivity rates, some people with RAIRD, particularly those on rituximab, had insufficient antibody levels despite three or four doses.
Keywords: SARS-CoV-2; antibody; rare autoimmune rheumatic diseases; rituximab; vaccination.