Antibody responses to inactivated and mRNA SARS-CoV-2 vaccines in familial Mediterranean fever patients treated with interleukin-1 inhibitors

Uğurlu, Serdal; Akçin, Rüveyda; Ayla, Ali Yagiz; Kocazeybek, Bekir; Öztaş, Mert; Can, Günay; Mustafayeva, Leyla; Saltoğlu, Neşe; Yilmaz, Betul; Özdoğan, Huri

doi:10.1093/rheumatology/keac123

Cited by 4 publications

(7 citation statements)

References 8 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All 729 FMF patients were adults (over 18 years) and 159 (22%) were receiving anti-IL-1 therapies. Most FMF patients ( n = 560, 76.8%) were vaccinated with the mRNA-based BNT162b2 vaccine, while 169 (23.2%) were vaccinated with the CoronaVac one [ 47 , 48 , 49 , 50 ]. These studies showed that FMF patients receiving mRNA BNT162b2 had higher antibody titers and lower infection rates than those receiving CoronaVac [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Myocarditis after SARS-CoV-2 vaccination has been widely reported in the medical literature [ 68 ], but none of the reports currently available were referred to patients affected by SAIDs covered by this review (FMF, CAPS, MKD, or PFAPA syndrome). Additionally, in no cited studies involving FMF patients undergoing SARS-CoV-2 vaccines [ 47 , 48 , 49 , 50 ] myocarditis was reported as a vaccination-related side effect. In the general population, the reported incidence of SARS-CoV-2-vaccine-related myocarditis is very low (2.13 per 100,000 people) [ 50 , 69 ], and therefore a much larger cohort of patients with FMF is needed to assess the susceptibility of patients with FMF to develop this adverse event.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, no randomized, controlled trials have been performed for patients with SAIDs undergoing either live-attenuated or non-live vaccines, with or without immunosuppressive and biologic therapies. Indeed, the studies available on SAIDs are small, mostly descriptive, and report variable results depending on the type of vaccine used [ 38 , 43 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ].…”

Section: General Data On Vaccinations In Systemic Autoinflammatory Di...mentioning

confidence: 99%

“…With regard to vaccine-induced protection against SARS-CoV-2 infection ( Table 1 ), patients with FMF have displayed a safety profile similar to that expected in the general population [ 59 ]. In particular, Ugurlu et al evaluated 48 adult patients with FMF on treatment with both canakinumab and anakinra (a recombinant human IL-1 receptor antagonist), 35 of whom were vaccinated with the inactivated CoronaVac and 13 with the mRNA BNT162b2 [ 47 ]. In detail, CoronaVac is an inactivated vaccine developed by the Chinese company Sinovac Biotech, having a good safety and efficacy profile in individuals aged 18 and over [ 60 ].…”

Section: Familial Mediterranean Fever and Vaccinationsmentioning

confidence: 99%

“…After the second dose, FMF patients vaccinated with BNT162b2 had higher antibody titers compared to those vaccinated with CoronaVac, but there were no statistically significant differences in antibody titers after the first dose. Therefore, anti-IL-1 therapy did not appear to affect the immune response to vaccines against SARS-CoV-2 [47]. Ozdede et al analyzed patients with FMF (n = 247), 53 of whom were receiving anti-IL-1 therapy (the drug was not specified).…”

Section: Familial Mediterranean Fever and Vaccinationsmentioning

confidence: 99%

See 4 more Smart Citations

Current Evidence on Vaccinations in Pediatric and Adult Patients with Systemic Autoinflammatory Diseases

et al. 2023

View full text Add to dashboard Cite

Systemic autoinflammatory diseases (SAIDs) are defined by recurrent febrile attacks associated with protean manifestations involving joints, the gastrointestinal tract, skin, and the central nervous system, combined with elevated inflammatory markers, and are caused by a dysregulation of the innate immune system. From a clinical standpoint, the most known SAIDs are familial Mediterranean fever (FMF); cryopyrin-associated periodic syndrome (CAPS); mevalonate kinase deficiency (MKD); and periodic fever, aphthosis, pharyngitis, and adenitis (PFAPA) syndrome. Current guidelines recommend the regular sequential administration of vaccines for all individuals with SAIDs. However, these patients have a much lower vaccination coverage rates in ‘real-world’ epidemiological studies than the general population. The main purpose of this review was to evaluate the scientific evidence available on both the efficacy and safety of vaccines in patients with SAIDs. From this analysis, neither serious adverse effects nor poorer antibody responses have been observed after vaccination in patients with SAIDs on treatment with biologic agents. More specifically, no new-onset immune-mediated complications have been observed following immunizations. Post-vaccination acute flares were significantly less frequent in FMF patients treated with colchicine alone than in those treated with both colchicine and canakinumab. Conversely, a decreased risk of SARS-CoV-2 infection has been proved for patients with FMF after vaccination with the mRNA-based BNT162b2 vaccine. Canakinumab did not appear to affect the ability to produce antibodies against non-live vaccines in patients with CAPS, especially if administered with a time lag from the vaccination. On the other hand, our analysis has shown that immunization against Streptococcus pneumoniae, specifically with the pneumococcal polysaccharide vaccine, was associated with a higher incidence of adverse reactions in CAPS patients. In addition, disease flares might be elicited by vaccinations in children with MKD, though no adverse events have been noted despite concurrent treatment with either anakinra or canakinumab. PFAPA patients seem to be less responsive to measles, mumps, and rubella-vaccine, but have shown higher antibody response than healthy controls following vaccination against hepatitis A. In consideration of the clinical frailty of both children and adults with SAIDs, all vaccinations remain ‘highly’ recommended in this category of patients despite the paucity of data available.

show abstract