Interaction of TNFi and conventional synthetic DMARD in SARS-CoV-2 vaccine response in axial spondyloarthritis and psoriatic arthritis - 15/01/23
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
Articolo gratuito.
Si connetta per beneficiarne
Highlights |
• | TNF inhibitors attenuate humoral response to SARS-CoV-2 vaccine in SpA patients. |
• | Sulfasalazine has a positive impact on vaccine antibody production. |
• | Vaccine humoral response was comparable between SpA patients without current DMARD/prednisone and control group. |
• | Pre-vaccination disease activity status did not influence humoral response. |
Abstract |
Objectives |
To evaluate humoral responses to three doses of the inactivated SARS-CoV-2 vaccine (CoronaVac) in patients with spondyloarthritis (SpA) and the effect of therapy, compared with a control group (CG).
Methods |
Prospective cohort of axial SpA/psoriatic arthritis patients and age/sex-balanced CG from the CoronavRheum phase 4 trial (NCT04754698). CoronaVac was given in two doses (28-days interval) with a booster at day 210. Blood samples were collected in the days 0/28 (D28)/69 (D69) and 240 (D240) to evaluate anti-SARS-CoV-2 IgG seropositivity (SP) and neutralising antibodies (NAb).
Results |
One hundred and ninety-four SpA patients were enrolled and 183 patients were age/sex-balanced with 183 CG. At D69, SpA patients showed a high SP (80.2% vs. 95.7%, P<0.001) and moderate NAb positivity (61.6% vs. 82.7%, P<0.001), but lower than CG. In patients, older age prednisone (P<0.001), methotrexate (MTX) (P<0.001) and TNF inhibitors (TNFi) (P<0.001) were independently associated with lower SP, while Caucasian ethnicity (P<0.05) and prednisone (P<0.01) were associated with diminished NAb. In contrast, sulfasalazine (SSZ) use was associated with NAb presence (P<0.05). In monotherapy, only TNFi was also associated with absence of SP (P<0.05). Further comparison with CG revealed that TNFi and/or MTX negatively impacted SP/NAb (P<0.05). In contrast, patients under SSZ monotherapy achieved 100% SP (P>0.999) and 83.3% NAb positivity (P>0.999). SSZ+TNFi combination resulted in a similar response than CG [SP (P=0.153) and NAb (P=0.715)]. After third dose (D69–D240), a major increment occurred for SP (81.3% to 93.1%, P<0.001) and NAb (63.2% to 86.1%, P<0.001), but still lower than CG (P<0.05), and only TNFi impaired both SP (P=0.016)/NAb (P=0.002).
Conclusions |
We provided novel data demonstrating that TNFi attenuates immunogenicity in SpA patients while SSZ has a positive impact on vaccine antibody production. We also confirmed that MTX in combination with TNFi had a major negative impact in vaccine humoral response (CoronavRheum clinicaltrials.gov #NCT04754698).
Il testo completo di questo articolo è disponibile in PDF.Keywords : Ankylosing spondylitis, Psoriatic arthritis, COVID-19, Vaccination, Therapeutics and TNFi
Mappa
Vol 90 - N° 1
Articolo 105464- Gennaio 2023 Ritorno al numero
Articolo precedente
- Musculoskeletal immune-related adverse events in 927 patients treated with immune checkpoint inhibitors for solid cancer
- Angélique Melia, Emilie Fockens, Patrick Sfumato, Christophe Zemmour, Anne Madroszyk, Pierre Lafforgue, Thao Pham
- Diagnostic utility of a second minor salivary gland biopsy in patients with suspected Sjögren's syndrome: A retrospective cohort study
- Guillermo Carvajal Alegria, Thibaud Depinoy, Valérie Devauchelle-Pensec, Sandrine Jousse-Joulin, Thierry Marhadour, Dewi Guellec, Pascale Marcorelles, Jacques-Olivier Pers, Alain Saraux, Divi Cornec
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.