HUMORAL and CELLULAR SARS-COV-2 VACCINE RESPONSES in PATIENTS with GIANT CELL ARTERITIS and POLYMYALGIA RHEUMATICA
Annals of the Rheumatic Diseases
; 81:373, 2022.
Article
in English
| EMBASE | ID: covidwho-2008868
ABSTRACT
Background:
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are overlapping autoinfammatory diseases affecting people over 50 years. The diseases are treated with immunosuppressive drugs such as prednisolone, metho-trexate, lefunomide and tocilizumab. Even though GCA and PMR patients have a substantially higher risk for infections, little is known about humoral and cellular immune responses after vaccination in these patients.Objectives:
In this study we assessed the immunogenicity and safety of SARS-CoV-2 vaccinations in these diseases.Methods:
Patients (n=45 GCA, n=33 PMR) visited the outpatient clinic twice pre-vaccination and 4 weeks post-vaccination (BNT162b2 or ChAdOx1 vaccine). Patients with previous SARS-CoV-2 infection were excluded. In both pre-and post-vaccination samples, anti-Spike antibody concentrations were assessed and compared to age-, sex-and vaccine-matched control groups (n=98). In addition, the frequency of SARS-CoV-2 Spike-specifc T-cells was assessed by IFN-γ ELIspot assay, and side-effects and disease activity were recorded.Results:
The GCA/PMR patients, as a group, did not have reduced antibody concentrations compared to controls. However, linear regression analysis revealed a signifcant association of methotrexate and >10mg/day prednisolone use with lower antibody concentrations in GCA/PMR patients. Evidence of cellular immunity, as assessed by ELIspot assay, was found in 67% of GCA/PMR patients, and was correlated with humoral immunity (Figure 1). Patients using >10mg/day prednisolone had reduced cellular immunity. Importantly, vaccination did not lead to signifcant side-effects or changes in disease activity.Conclusion:
SARS-CoV-2 vaccination was safe for GCA/PMR patients and immunogenicity was comparable to other older individuals. However, patients using methotrexate and particularly >10mg/day prednisolone did show lower vaccine responses, which corroborates fndings in other autoinfammatory patient populations. These patients may therefore be at higher risk of (potentially even severe) breakthrough SARS-CoV-2 infection.
endogenous compound; gamma interferon; methotrexate; prednisolone; tozinameran; vaxzevria; adult; cellular immunity; conference abstract; controlled study; coronavirus disease 2019; enzyme linked immunospot assay; female; gene frequency; giant cell arteritis; human; humoral immunity; immunogenicity; linear regression analysis; low drug dose; major clinical study; male; nonhuman; outpatient department; rheumatic polymyalgia; Severe acute respiratory syndrome coronavirus 2; side effect; spike; T lymphocyte; vaccination
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Annals of the Rheumatic Diseases
Year:
2022
Document Type:
Article
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