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Serological response to SARS-CoV-2 vaccination in patients with inflammatory rheumatic disease treated with disease modifying anti-rheumatic drugs: A cohort study and a meta-analysis.
Auroux, Maxime; Laurent, Benjamin; Coste, Baptiste; Massy, Emmanuel; Mercier, Alexandre; Durieu, Isabelle; Confavreux, Cyrille B; Lega, Jean-Christophe; Mainbourg, Sabine; Coury, Fabienne.
  • Auroux M; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Laurent B; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Coste B; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Massy E; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Mercier A; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Durieu I; Department of Internal and Vascular Medicine, Hôpital Lyon Sud, Hospices Civils de Lyon, RESHAPE-INSERM U1290, Research on Healthcare Performance, Claude Bernard University Lyon 1, Lyon, France.
  • Confavreux CB; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France.
  • Lega JC; Department of Internal and Vascular Medicine, Hôpital Lyon Sud, Hospices Civils de Lyon, UMR - CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, Claude Bernard University Lyon 1, Lyon, France; Lyon Immunopathology Federation, Lyon, France.
  • Mainbourg S; Department of Internal and Vascular Medicine, Hôpital Lyon Sud, Hospices Civils de Lyon, UMR - CNRS 5558, Laboratoire de Biométrie et Biologie Évolutive, Claude Bernard University Lyon 1, Lyon, France; Lyon Immunopathology Federation, Lyon, France.
  • Coury F; Department of Rheumatology, Hôpital Lyon Sud, Hospices Civils de Lyon, INSERM UMR -1033, Pathophysiology, diagnosis and treatments of muskuloskeletal disorders, Claude Bernard University Lyon 1, Lyon, France; Lyon Immunopathology Federation, Lyon, France. Electronic address: fabienne.coury-lucas@chu
Joint Bone Spine ; 89(5): 105380, 2022 10.
Article in English | MEDLINE | ID: covidwho-1873116
ABSTRACT

INTRODUCTION:

Vaccination is considered as a cornerstone of the management of COVID-19 pandemic. However, while vaccines provide a robust protection in immunocompetent individuals, the immunogenicity in patients with inflammatory rheumatic diseases (IRD) is not well established.

METHODS:

A monocentric observational study evaluated the immunogenicity of a two-dose regimen vaccine in adult patients with IRD (n=123) treated with targeted or biological therapies. Serum IgG antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins were measured after the second vaccination. In addition, a search for observational studies performed in IRD under biologic or targeted therapies up to September 31, 2021 (PROSPERO registration number CRD42021259410) was undertaken in publication databases, preprint servers, and grey literature sources. Studies that reported sample size, study date, location, and seroprevalence estimate were included. A meta-analysis was conducted to identify demographic differences in the prevalence of SARS-CoV-2 antibodies.

RESULTS:

Of 123 patients (median age 66 IQR 57-75), 69.9% have seroconverted after vaccination. Seroconverted patients were older than non-seroconverted ones in our cohort. Rituximab was associated with a significantly low antibody response. Besides, we identified 20 seroprevalence studies in addition to our cohort including 4423 participants in 11 countries. Meta-analysis confirmed a negative impact of rituximab on seroconversion rate and suggested a less substantial effect of abatacept, leflunomide and methotrexate.

CONCLUSION:

Rituximab impairs serological response to SARS-CoV-2 vaccines in patients with IRD. This work suggests also a negative impact of abatacept, methotrexate or leflunomide especially when associated to biological therapy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Adult / Aged / Humans Language: English Journal: Joint Bone Spine Journal subject: Rheumatology Year: 2022 Document Type: Article Affiliation country: J.jbspin.2022.105380

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Adult / Aged / Humans Language: English Journal: Joint Bone Spine Journal subject: Rheumatology Year: 2022 Document Type: Article Affiliation country: J.jbspin.2022.105380