Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring

We report a case of monitoring the antibody response to the BioNTech–Pfizer vaccine of a 50-year-old female diagnosed with rheumatoid arthritis undergoing treatment with methotrexate (MTX). Antibody levels were measured 21 days after dose 1 (i.e., on the day of dose 2) and then 8, 14 and 30 days aft...

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Main Authors: Krzysztof Lukaszuk, Izabela Woclawek-Potocka, Grzegorz Jakiel, Paulina Malinowska, Artur Wdowiak, Karolina Rozanska, Lukasz Rabalski
Format: Article
Language:English
Published: MDPI AG 2021-10-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/9/10/1151
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author Krzysztof Lukaszuk
Izabela Woclawek-Potocka
Grzegorz Jakiel
Paulina Malinowska
Artur Wdowiak
Karolina Rozanska
Lukasz Rabalski
author_facet Krzysztof Lukaszuk
Izabela Woclawek-Potocka
Grzegorz Jakiel
Paulina Malinowska
Artur Wdowiak
Karolina Rozanska
Lukasz Rabalski
author_sort Krzysztof Lukaszuk
collection DOAJ
description We report a case of monitoring the antibody response to the BioNTech–Pfizer vaccine of a 50-year-old female diagnosed with rheumatoid arthritis undergoing treatment with methotrexate (MTX). Antibody levels were measured 21 days after dose 1 (i.e., on the day of dose 2) and then 8, 14 and 30 days after dose 2 with Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics). Patient showed a negative result after dose 1 and had the serum sample retested using a LIAISON<sup>®</sup> SARS-CoV-2 TrimericS IgG assay (DiaSorin), which showed a positive result. Subsequent samples were tested using both assays. Antibody levels kept increasing but at a much slower rate than in patients not receiving any immunomodulatory therapies. Other research indicates that among patients with autoimmune diseases, those receiving disease-modifying antirheumatic drugs (DMARDs) have higher COVID-19 mortality than those treated with tumor necrosis factor inhibitors (TNFis). These results indicate the need for people with autoimmune diseases to be carefully observed following vaccinations, including testing of antibody levels, and treated as potentially at risk until the effect of vaccination is confirmed. The different available vaccines should also be tested to verify their usefulness in the case of people with autoimmune diseases and those who take different immunomodulatory medications.
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spelling doaj.art-ddd1242954be4acbb62a44a2950b47cd2023-11-22T20:15:59ZengMDPI AGVaccines2076-393X2021-10-01910115110.3390/vaccines9101151Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of MonitoringKrzysztof Lukaszuk0Izabela Woclawek-Potocka1Grzegorz Jakiel2Paulina Malinowska3Artur Wdowiak4Karolina Rozanska5Lukasz Rabalski6Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-211 Gdansk, PolandDepartment of Gamete and Embryo Biology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-243 Olsztyn, PolandThe Center of Postgraduate Medical Education, 1st Department of Obstetrics and Gynecology, 01-004 Warsaw, PolandInvicta Research and Development Center, 81-740 Sopot, PolandDiagnostic Techniques Unit, Medical University of Lublin, 20-081 Lublin, PolandInvicta Research and Development Center, 81-740 Sopot, PolandLaboratory of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, PolandWe report a case of monitoring the antibody response to the BioNTech–Pfizer vaccine of a 50-year-old female diagnosed with rheumatoid arthritis undergoing treatment with methotrexate (MTX). Antibody levels were measured 21 days after dose 1 (i.e., on the day of dose 2) and then 8, 14 and 30 days after dose 2 with Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics). Patient showed a negative result after dose 1 and had the serum sample retested using a LIAISON<sup>®</sup> SARS-CoV-2 TrimericS IgG assay (DiaSorin), which showed a positive result. Subsequent samples were tested using both assays. Antibody levels kept increasing but at a much slower rate than in patients not receiving any immunomodulatory therapies. Other research indicates that among patients with autoimmune diseases, those receiving disease-modifying antirheumatic drugs (DMARDs) have higher COVID-19 mortality than those treated with tumor necrosis factor inhibitors (TNFis). These results indicate the need for people with autoimmune diseases to be carefully observed following vaccinations, including testing of antibody levels, and treated as potentially at risk until the effect of vaccination is confirmed. The different available vaccines should also be tested to verify their usefulness in the case of people with autoimmune diseases and those who take different immunomodulatory medications.https://www.mdpi.com/2076-393X/9/10/1151COVID-19vaccinationmethotrexateTNFisautoimmune diseaseAIIRD
spellingShingle Krzysztof Lukaszuk
Izabela Woclawek-Potocka
Grzegorz Jakiel
Paulina Malinowska
Artur Wdowiak
Karolina Rozanska
Lukasz Rabalski
Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
Vaccines
COVID-19
vaccination
methotrexate
TNFis
autoimmune disease
AIIRD
title Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
title_full Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
title_fullStr Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
title_full_unstemmed Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
title_short Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring
title_sort humoral response to sars cov 2 vaccine of a patient receiving methotrexate treatment and implications for the need of monitoring
topic COVID-19
vaccination
methotrexate
TNFis
autoimmune disease
AIIRD
url https://www.mdpi.com/2076-393X/9/10/1151
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