Anne Troldborg1, Marianne Kragh Thomsen2, Lars Erik Bartels3, Jakob Bøgh Andersen3, Signe Risbøl Vils4, Clara Elbæk Mistegaard5, Anders Dahl Johannsen3, Marie-Louise From Hermansen3, Susan Mikkelsen6, Christian Erikstrup7, Ellen-Margrethe Hauge8, Christian Ammitzbøll8. 1. A. Troldborg, MD, PhD, Department of Rheumatology, Aarhus University Hospital, Department of Biomedicine, and Department of Clinical Medicine, Aarhus University; annetrol@rm.dk. 2. M.K. Thomsen, MD, Department of Clinical Medicine, Aarhus University, and Department of Clinical Microbiology, Aarhus University Hospital. 3. L.E. Bartels, MD, PhD, J.B. Andersen, MD, A.D. Johannsen, MD, M.L.F. Hermansen, MD, PhD, Department of Rheumatology, Aarhus University Hospital. 4. S.R. Vils MS, Department of Rheumatology, Aarhus University Hospital, and Department of Biomedicine, Aarhus University. 5. C.E. Mistegaard, MD, Department of Rheumatology, and Department of Clinical Microbiology, Aarhus University Hospital, and Department of Biomedicine, Aarhus University. 6. S. Mikkelsen, MD, Department of Clinical Immunology, Aarhus University Hospital. 7. C. Erikstrup, MD, PhD, Department of Clinical Medicine, Aarhus University, and Department of Clinical Immunology, Aarhus University Hospital. 8. E.M. Hauge, MD, PhD, C. Ammitzbøll, MD, PhD, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Abstract
OBJECTIVE: We aimed to investigate (1) whether patients with rheumatic disease (RD) treated with rituximab (RTX) raise a serological response toward the coronavirus disease 2019 (COVID-19) mRNA vaccines, and (2) to elucidate the influence of time since the last RTX dose before vaccination on this response. METHODS: We identified and included 201 patients with RDs followed at the outpatient clinic at the Department of Rheumatology, Aarhus University Hospital, who had been treated with RTX in the period 2017-2021 and who had completed their 2-dose vaccination series with a COVID-19 mRNA vaccine. Total antibodies against the SARS-CoV-2 spike protein were measured on all patients and 44 blood donors as 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 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 RDs treated with RTX have a severely impaired serological response toward COVID-19 mRNA vaccines. Our data suggest that the current recommendations of a 6-month interval between RTX treatment and vaccination should be reevaluated.
OBJECTIVE: We aimed to investigate (1) whether patients with rheumatic disease (RD) treated with rituximab (RTX) raise a serological response toward the coronavirus disease 2019 (COVID-19) mRNA vaccines, and (2) to elucidate the influence of time since the last RTX dose before vaccination on this response. METHODS: We identified and included 201 patients with RDs followed at the outpatient clinic at the Department of Rheumatology, Aarhus University Hospital, who had been treated with RTX in the period 2017-2021 and who had completed their 2-dose vaccination series with a COVID-19 mRNA vaccine. Total antibodies against the SARS-CoV-2 spike protein were measured on all patients and 44 blood donors as 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 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 RDs treated with RTX have a severely impaired serological response toward COVID-19 mRNA vaccines. Our data suggest that the current recommendations of a 6-month interval between RTX treatment and vaccination should be reevaluated.
Authors: Christian Ammitzbøll; Marianne Kragh Thomsen; Jakob Bøgh Andersen; Lars Erik Bartels; Marie-Louise From Hermansen; Anders Dahl Johannsen; Clara Elbæk Mistegaard; Susan Mikkelsen; Signe Risbøl Vils; Christian Erikstrup; Ellen-Margrethe Hauge; Anne Troldborg Journal: Mod Rheumatol Date: 2022-07-21 Impact factor: 2.862