The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination
ObjectivesThis 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...
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| Format: | Article |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1049157/full |
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| author | Selma Tobudic Elisabeth Simader Thomas Deimel Jennifer Straub Felix Kartnig Leonhard X. Heinz Peter Mandl Helmuth Haslacher Thomas Perkmann Lisa Schneider Thomas Nothnagl Helga Radner Florian Winkler Florian Winkler Heinz Burgmann Karin Stiasny Gottfried Novacek Walter Reinisch Daniel Aletaha Stefan Winkler Stephan Blüml |
| author_facet | Selma Tobudic Elisabeth Simader Thomas Deimel Jennifer Straub Felix Kartnig Leonhard X. Heinz Peter Mandl Helmuth Haslacher Thomas Perkmann Lisa Schneider Thomas Nothnagl Helga Radner Florian Winkler Florian Winkler Heinz Burgmann Karin Stiasny Gottfried Novacek Walter Reinisch Daniel Aletaha Stefan Winkler Stephan Blüml |
| author_sort | Selma Tobudic |
| collection | DOAJ |
| description | ObjectivesThis 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.MethodsWe 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.ResultsPatients 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.ConclusionPatients 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. |
| first_indexed | 2024-04-10T16:23:18Z |
| format | Article |
| id | doaj.art-2cad56ed1e794e2eaa887e25d6c656e3 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T16:23:18Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-2cad56ed1e794e2eaa887e25d6c656e32023-02-09T09:25:14ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-02-011010.3389/fmed.2023.10491571049157The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccinationSelma Tobudic0Elisabeth Simader1Thomas Deimel2Jennifer Straub3Felix Kartnig4Leonhard X. Heinz5Peter Mandl6Helmuth Haslacher7Thomas Perkmann8Lisa Schneider9Thomas Nothnagl10Helga Radner11Florian Winkler12Florian Winkler13Heinz Burgmann14Karin Stiasny15Gottfried Novacek16Walter Reinisch17Daniel Aletaha18Stefan Winkler19Stephan Blüml20Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, Vienna, AustriaDepartment of Laboratory Medicine, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaDepartment of Second Medical, Lower Austrian Centre for Rheumatology, Korneuburg-Stockerau Hospital, Stockerau, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaCenter for Virology, Medical University of Vienna, Vienna, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, AustriaObjectivesThis 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.MethodsWe 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.ResultsPatients 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.ConclusionPatients 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.1049157/fullSARS-CoV-2arthritisIBDhumoral immune responseimmunomodulatory therapybDMARD |
| spellingShingle | Selma Tobudic Elisabeth Simader Thomas Deimel Jennifer Straub Felix Kartnig Leonhard X. Heinz Peter Mandl Helmuth Haslacher Thomas Perkmann Lisa Schneider Thomas Nothnagl Helga Radner Florian Winkler Florian Winkler Heinz Burgmann Karin Stiasny Gottfried Novacek Walter Reinisch Daniel Aletaha Stefan Winkler Stephan Blüml The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination Frontiers in Medicine SARS-CoV-2 arthritis IBD humoral immune response immunomodulatory therapy bDMARD |
| 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 | SARS-CoV-2 arthritis IBD humoral immune response immunomodulatory therapy bDMARD |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1049157/full |
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