COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab

Christian Ammitzbøll; Marianne Kragh Thomsen; Lars Erik Bartels; Cecilie Bo Hansen; Marie-Louise From Hermansen; Mathias Hänel; Rasmus Klose-Jensen; Mads Lamm Larsen; Morgan Oliver Lauritsen; Clara Elbæk Mistegaard; Susan Mikkelsen; Janne Bille Mønster Olesen; Esben Uggerby Næser; Morten Aagaard Nielsen; Christian Erikstrup; Peter Garred; Ellen-Margrethe Hauge; Anne Troldborg

doi:10.1002/acr2.11681

COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab

Christian Ammitzbøll, Marianne Kragh Thomsen, Lars Erik Bartels, Cecilie Bo Hansen, Marie-Louise From Hermansen, Mathias Hänel, Rasmus Klose-Jensen, Mads Lamm Larsen, Morgan Oliver Lauritsen, Clara Elbæk Mistegaard, Susan Mikkelsen, Janne Bille Mønster Olesen, Esben Uggerby Næser, Morten Aagaard Nielsen, Christian Erikstrup, Peter Garred, Ellen-Margrethe Hauge, Anne Troldborg

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

1 Citationer (Scopus)

Abstract

Objective: Rituximab (RTX)-treated patients exhibit suboptimal responses to COVID-19 vaccines. However, existing research primarily involves patients already receiving RTX when vaccines were introduced, failing to account for the current landscape where patients are vaccinated before initiating RTX. Our objective was to compare the serological response to COVID-19 vaccines in patients vaccinated before or after RTX initiation. Methods: We included 254 RTX-treated patients with autoimmune inflammatory rheumatic diseases (AIIRDs) and 113 blood donors (BDs) in a retrospective, observational cohort study. Patients were categorized based on the timing of RTX treatment relative to primary COVID-19 vaccination. Serological vaccine responses were assessed using three immunoassays, and logistic regression analysis was used to identify predictors of serological response. Results: Patients vaccinated before initiating RTX treatment had significantly higher seroconversion rates of SARS-CoV-2 immunoglobulin G (87%) and neutralizing antibodies (91%) compared with those receiving RTX before and after vaccination (n = 132) (61% and 65%, respectively). In the logistic regression analysis, a positive serological response was associated with the number of vaccines administered >9 months after the last RTX treatment. Patients receiving the highest number of vaccines with >9 months after RTX showed a response comparable to that of the BDs. Conclusion: Vaccinating before RTX initiation yields a robust serological response in patients with AIIRDs. Furthermore, we highlight the reversibility of antibody impairment after RTX treatment cessation, provided that adequate vaccinations occur within a minimum of 9 months after RTX. Our findings offer essential insights for clinical decision-making regarding COVID-19 vaccination and RTX treatment, alleviating concerns about future RTX use. (Figure presented.).

Originalsprog	Engelsk
Tidsskrift	ACR Open Rheumatology
Vol/bind	6
Nummer	8
Sider (fra-til)	519-528
Antal sider	10
DOI	https://doi.org/10.1002/acr2.11681
Status	Udgivet - aug. 2024

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Ammitzbøll, C., Thomsen, M. K., Bartels, L. E., Hansen, C. B., Hermansen, M.-L. F., Hänel, M., Klose-Jensen, R., Larsen, M. L., Lauritsen, M. O., Mistegaard, C. E., Mikkelsen, S., Olesen, J. B. M., Næser, E. U., Nielsen, M. A., Erikstrup, C., Garred, P., Hauge, E.-M., & Troldborg, A. (2024). COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab. ACR Open Rheumatology, 6(8), 519-528. https://doi.org/10.1002/acr2.11681

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title = "COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab",

abstract = "Objective: Rituximab (RTX)-treated patients exhibit suboptimal responses to COVID-19 vaccines. However, existing research primarily involves patients already receiving RTX when vaccines were introduced, failing to account for the current landscape where patients are vaccinated before initiating RTX. Our objective was to compare the serological response to COVID-19 vaccines in patients vaccinated before or after RTX initiation. Methods: We included 254 RTX-treated patients with autoimmune inflammatory rheumatic diseases (AIIRDs) and 113 blood donors (BDs) in a retrospective, observational cohort study. Patients were categorized based on the timing of RTX treatment relative to primary COVID-19 vaccination. Serological vaccine responses were assessed using three immunoassays, and logistic regression analysis was used to identify predictors of serological response. Results: Patients vaccinated before initiating RTX treatment had significantly higher seroconversion rates of SARS-CoV-2 immunoglobulin G (87%) and neutralizing antibodies (91%) compared with those receiving RTX before and after vaccination (n = 132) (61% and 65%, respectively). In the logistic regression analysis, a positive serological response was associated with the number of vaccines administered >9 months after the last RTX treatment. Patients receiving the highest number of vaccines with >9 months after RTX showed a response comparable to that of the BDs. Conclusion: Vaccinating before RTX initiation yields a robust serological response in patients with AIIRDs. Furthermore, we highlight the reversibility of antibody impairment after RTX treatment cessation, provided that adequate vaccinations occur within a minimum of 9 months after RTX. Our findings offer essential insights for clinical decision-making regarding COVID-19 vaccination and RTX treatment, alleviating concerns about future RTX use. (Figure presented.).",

author = "Christian Ammitzb{\o}ll and Thomsen, {Marianne Kragh} and Bartels, {Lars Erik} and Hansen, {Cecilie Bo} and Hermansen, {Marie-Louise From} and Mathias H{\"a}nel and Rasmus Klose-Jensen and Larsen, {Mads Lamm} and Lauritsen, {Morgan Oliver} and Mistegaard, {Clara Elb{\ae}k} and Susan Mikkelsen and Olesen, {Janne Bille M{\o}nster} and N{\ae}ser, {Esben Uggerby} and Nielsen, {Morten Aagaard} and Christian Erikstrup and Peter Garred and Ellen-Margrethe Hauge and Anne Troldborg",

year = "2024",

month = aug,

doi = "10.1002/acr2.11681",

language = "English",

volume = "6",

pages = "519--528",

journal = "ACR Open Rheumatology",

issn = "2578-5745",

publisher = "John Wiley & Sons Inc.",

number = "8",

}

Ammitzbøll, C , Thomsen, MK , Bartels, LE, Hansen, CB, Hermansen, M-LF, Hänel, M , Klose-Jensen, R, Larsen, ML, Lauritsen, MO, Mistegaard, CE , Mikkelsen, S, Olesen, JBM, Næser, EU , Nielsen, MA , Erikstrup, C, Garred, P, Hauge, E-M & Troldborg, A 2024, 'COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab', ACR Open Rheumatology, bind 6, nr. 8, s. 519-528. https://doi.org/10.1002/acr2.11681

COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab. / Ammitzbøll, Christian ; Thomsen, Marianne Kragh ; Bartels, Lars Erik et al.
I: ACR Open Rheumatology, Bind 6, Nr. 8, 08.2024, s. 519-528.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab

AU - Ammitzbøll, Christian

AU - Thomsen, Marianne Kragh

AU - Bartels, Lars Erik

AU - Hansen, Cecilie Bo

AU - Hermansen, Marie-Louise From

AU - Hänel, Mathias

AU - Klose-Jensen, Rasmus

AU - Larsen, Mads Lamm

AU - Lauritsen, Morgan Oliver

AU - Mistegaard, Clara Elbæk

AU - Mikkelsen, Susan

AU - Olesen, Janne Bille Mønster

AU - Næser, Esben Uggerby

AU - Nielsen, Morten Aagaard

AU - Erikstrup, Christian

AU - Garred, Peter

AU - Hauge, Ellen-Margrethe

AU - Troldborg, Anne

PY - 2024/8

Y1 - 2024/8

N2 - Objective: Rituximab (RTX)-treated patients exhibit suboptimal responses to COVID-19 vaccines. However, existing research primarily involves patients already receiving RTX when vaccines were introduced, failing to account for the current landscape where patients are vaccinated before initiating RTX. Our objective was to compare the serological response to COVID-19 vaccines in patients vaccinated before or after RTX initiation. Methods: We included 254 RTX-treated patients with autoimmune inflammatory rheumatic diseases (AIIRDs) and 113 blood donors (BDs) in a retrospective, observational cohort study. Patients were categorized based on the timing of RTX treatment relative to primary COVID-19 vaccination. Serological vaccine responses were assessed using three immunoassays, and logistic regression analysis was used to identify predictors of serological response. Results: Patients vaccinated before initiating RTX treatment had significantly higher seroconversion rates of SARS-CoV-2 immunoglobulin G (87%) and neutralizing antibodies (91%) compared with those receiving RTX before and after vaccination (n = 132) (61% and 65%, respectively). In the logistic regression analysis, a positive serological response was associated with the number of vaccines administered >9 months after the last RTX treatment. Patients receiving the highest number of vaccines with >9 months after RTX showed a response comparable to that of the BDs. Conclusion: Vaccinating before RTX initiation yields a robust serological response in patients with AIIRDs. Furthermore, we highlight the reversibility of antibody impairment after RTX treatment cessation, provided that adequate vaccinations occur within a minimum of 9 months after RTX. Our findings offer essential insights for clinical decision-making regarding COVID-19 vaccination and RTX treatment, alleviating concerns about future RTX use. (Figure presented.).

AB - Objective: Rituximab (RTX)-treated patients exhibit suboptimal responses to COVID-19 vaccines. However, existing research primarily involves patients already receiving RTX when vaccines were introduced, failing to account for the current landscape where patients are vaccinated before initiating RTX. Our objective was to compare the serological response to COVID-19 vaccines in patients vaccinated before or after RTX initiation. Methods: We included 254 RTX-treated patients with autoimmune inflammatory rheumatic diseases (AIIRDs) and 113 blood donors (BDs) in a retrospective, observational cohort study. Patients were categorized based on the timing of RTX treatment relative to primary COVID-19 vaccination. Serological vaccine responses were assessed using three immunoassays, and logistic regression analysis was used to identify predictors of serological response. Results: Patients vaccinated before initiating RTX treatment had significantly higher seroconversion rates of SARS-CoV-2 immunoglobulin G (87%) and neutralizing antibodies (91%) compared with those receiving RTX before and after vaccination (n = 132) (61% and 65%, respectively). In the logistic regression analysis, a positive serological response was associated with the number of vaccines administered >9 months after the last RTX treatment. Patients receiving the highest number of vaccines with >9 months after RTX showed a response comparable to that of the BDs. Conclusion: Vaccinating before RTX initiation yields a robust serological response in patients with AIIRDs. Furthermore, we highlight the reversibility of antibody impairment after RTX treatment cessation, provided that adequate vaccinations occur within a minimum of 9 months after RTX. Our findings offer essential insights for clinical decision-making regarding COVID-19 vaccination and RTX treatment, alleviating concerns about future RTX use. (Figure presented.).

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U2 - 10.1002/acr2.11681

DO - 10.1002/acr2.11681

M3 - Journal article

C2 - 38923834

SN - 2578-5745

VL - 6

SP - 519

EP - 528

JO - ACR Open Rheumatology

JF - ACR Open Rheumatology

IS - 8

ER -

COVID-19 Vaccination Before Initiating Rituximab Treatment Induces Strong Serological Response in Autoimmune Rheumatic Disease, Reducing Post-Pandemic Concerns About the Impact of Rituximab

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