Rituximab-treated rheumatic patients: B-cells predict seroconversion after COVID-19 boost or revaccination in initial vaccine non-responders.
Rheumatology (Oxford)
; 2022 Nov 29.
Article
in English
| MEDLINE | ID: covidwho-2135575
ABSTRACT
OBJECTIVES:
To investigate the effect of either a booster vaccine (one dose) or revaccination (two doses three weeks apart) on the antibody response to the COVID-19 mRNA vaccines in patients with rheumatic disease (RD) treated with Rituximab (RTX), who had not produced vaccine-reactive antibodies after the initial two vaccine doses. Further, to examine if B cell levels in peripheral blood predicted seroconversion.METHODS:
We included 91 RTX-treated RD patients previously vaccinated against COVID-19. Patients were offered revaccination or a single booster vaccination with an mRNA vaccine. Serum total antibodies against SARS-CoV-2 spike protein were measured before and six weeks after the last vaccine dose. B-cells (CD19+CD45+) were measured by flow cytometry at inclusion.RESULTS:
Of RD patients with undetectable SARS-CoV-2 antibody levels before inclusion, seroconversion was seen in 38% six weeks after the booster dose and 32% after revaccination. Patients receiving revaccination had significantly higher antibody levels than patients receiving a booster dose (p< 0.001). In both univariate and multivariate logistic regression analysis, only B-cells higher than 10/µL before boost or revaccination were associated with seroconversion (p= 0.009 and p= 0.01, respectively). Seroconversion was independent of age, gender, diagnosis, cumulative RTX dose, RTX treatment time, and time since last RTX treatment.CONCLUSION:
Continuously impaired humoral response to mRNA vaccines was found in most RTX treated patients after a booster dose or revaccination. Seroconversion was observed in approximately one-third of the patients. Measurable B-cells before boosting or revaccination was the strongest predictor of antibody response after boost or revaccination.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal subject:
Rheumatology
Year:
2022
Document Type:
Article
Affiliation country:
Rheumatology
Similar
MEDLINE
...
LILACS
LIS