Your browser doesn't support javascript.
Pausing methotrexate improves immunogenicity of COVID-19 vaccination in elderly patients with rheumatic diseases.
Arumahandi de Silva, Amanthi Nadira; Frommert, Leonie Maria; Albach, Fredrik N; Klotsche, Jens; Scholz, Veronika; Jeworowski, Lara Maria; Schwarz, Tatjana; Ten Hagen, Alexander; Zernicke, Jan; Corman, Victor Max; Drosten, Christian; Burmester, Gerd-Rüdiger; Biesen, Robert.
  • Arumahandi de Silva AN; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Frommert LM; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Albach FN; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Klotsche J; Epidemiology Unit, German Rheumatism Research Center Berlin - a Leibniz Institute (DRFZ), Berlin, Germany.
  • Scholz V; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Jeworowski LM; Institute of Virology, Charité Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Schwarz T; Institute of Virology, Charité Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Ten Hagen A; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Zernicke J; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
  • Corman VM; Institute of Virology, Charité Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Drosten C; Labor Berlin, Charité - Vivantes GmbH, Berlin, Germany.
  • Burmester GR; Institute of Virology, Charité Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany.
  • Biesen R; Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität, Berlin, Germany.
Ann Rheum Dis ; 81(6): 881-888, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1741593
ABSTRACT

OBJECTIVE:

To study the effect of methotrexate (MTX) and its discontinuation on the humoral immune response after COVID-19 vaccination in patients with autoimmune rheumatic diseases (AIRD).

METHODS:

In this retrospective study, neutralising SARS-CoV-2 antibodies were measured after second vaccination in 64 patients with AIRD on MTX therapy, 31 of whom temporarily paused medication without a fixed regimen. The control group consisted of 21 patients with AIRD without immunosuppressive medication.

RESULTS:

Patients on MTX showed a significantly lower mean antibody response compared with patients with AIRD without immunosuppressive therapy (71.8% vs 92.4%, p<0.001). For patients taking MTX, age correlated negatively with immune response (r=-0.49; p<0.001). All nine patients with antibody levels below the cut-off were older than 60 years. Patients who held MTX during at least one vaccination showed significantly higher mean neutralising antibody levels after second vaccination, compared with patients who continued MTX therapy during both vaccinations (83.1% vs 61.2%, p=0.001). This effect was particularly pronounced in patients older than 60 years (80.8% vs 51.9%, p=0.001). The impact of the time period after vaccination was greater than of the time before vaccination with the critical cut-off being 10 days.

CONCLUSION:

MTX reduces the immunogenicity of SARS-CoV-2 vaccination in an age-dependent manner. Our data further suggest that holding MTX for at least 10 days after vaccination significantly improves the antibody response in patients over 60 years of age.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Rheumatic Diseases / COVID-19 Type of study: Observational study Topics: Vaccines Limits: Aged / Humans / Middle aged Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2021-221876

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Rheumatic Diseases / COVID-19 Type of study: Observational study Topics: Vaccines Limits: Aged / Humans / Middle aged Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2021-221876