Time since rituximab treatment is essential for developing a humoral response to COVID-19 mRNA vaccines in patients with rheumatic diseases

TY - JOUR

T1 - Time since rituximab treatment is essential for developing a humoral response to COVID-19 mRNA vaccines in patients with rheumatic diseases

AU - Troldborg, Anne

AU - Thomsen, Marianne Kragh

AU - Bartels, Lars Erik

AU - Andersen, Jakob Bøgh

AU - Vils, Signe Risbøl

AU - Mistegaard, Clara Elbæk

AU - Johannsen, Anders Dahl

AU - Hermansen, Marie-Louise From

AU - Mikkelsen, Susan

AU - Erikstrup, Christian

AU - Hauge, Ellen-Margrethe

AU - Ammitzbøll, Christian

PY - 2022/6

Y1 - 2022/6

N2 - OBJECTIVE: We aimed to investigate if patients with rheumatic diseases treated with rituximab raise a serological response towards the COVID-19 mRNA vaccines and to elucidate the influence of time since the last dose RTX before vaccination on this response.METHODS: We identified and included 201 patients with rheumatic diseases followed at the out-patient clinic at the Department of Rheumatology, Aarhus University Hospital, who had been treated with RTX in the period 2017-2021 and who had finished their two-dose vaccination with a COVID-19 mRNA vaccine. Total antibodies against SARS-CoV2 spike protein were measured on all patients and 44 blood donors as a reference.RESULTS: We observed a time-dependent increase in antibody response as the interval from the last RTX treatment to vaccination increased. Only 17.3% of patients developed a detectable antibody response after receiving their vaccination 6 months or less after their previous RTX treatment. Positive antibody response increased to 66.7% in patients who had RTX 9-12 months before vaccination. All blood donors (100%) had detectable antibodies after vaccination.CONCLUSION: Patients with rheumatic diseases treated with rituximab have a severely impaired serological response towards the COVID-19 mRNA vaccine. Our data suggest that the current recommendations of a 6 months interval between rituximab treatment and vaccination should be revised.

AB - OBJECTIVE: We aimed to investigate if patients with rheumatic diseases treated with rituximab raise a serological response towards the COVID-19 mRNA vaccines and to elucidate the influence of time since the last dose RTX before vaccination on this response.METHODS: We identified and included 201 patients with rheumatic diseases followed at the out-patient clinic at the Department of Rheumatology, Aarhus University Hospital, who had been treated with RTX in the period 2017-2021 and who had finished their two-dose vaccination with a COVID-19 mRNA vaccine. Total antibodies against SARS-CoV2 spike protein were measured on all patients and 44 blood donors as a reference.RESULTS: We observed a time-dependent increase in antibody response as the interval from the last RTX treatment to vaccination increased. Only 17.3% of patients developed a detectable antibody response after receiving their vaccination 6 months or less after their previous RTX treatment. Positive antibody response increased to 66.7% in patients who had RTX 9-12 months before vaccination. All blood donors (100%) had detectable antibodies after vaccination.CONCLUSION: Patients with rheumatic diseases treated with rituximab have a severely impaired serological response towards the COVID-19 mRNA vaccine. Our data suggest that the current recommendations of a 6 months interval between rituximab treatment and vaccination should be revised.

KW - autoimmune diseases

KW - rheumatic diseases

KW - vaccination

KW - vaccines

UR - http://www.scopus.com/inward/record.url?scp=85131268063&partnerID=8YFLogxK

U2 - 10.3899/jrheum.211152

DO - 10.3899/jrheum.211152

M3 - Journal article

C2 - 35232803

SN - 0315-162X

VL - 49

SP - 644

EP - 649

JO - The Journal of Rheumatology

JF - The Journal of Rheumatology

IS - 6

ER -