Immunogenicity of three doses of anti-SARS-CoV-2 BNT162b2 vaccine in psoriasis patients treated with biologics

Abstract

IntroductionPsoriasis has not been directly linked to a poor prognosis for COVID-19, yet immunomodulatory agents used for its management may lead to increased vulnerability to the dangerous complications of SARS-CoV-2 infection, as well as impair the effectiveness of the recently introduced vaccines. The three-dose antibody response trend and the safety of BNT162b2 mRNA vaccine in psoriasis patients treated with biologic drugs have remained under-researched.Materials and methodsForty-five psoriatic patients on biologic treatment were enrolled to evaluate their humoral response to three doses of BNT162b2. IgG titers anti-SARS-CoV-2 spike protein were evaluated at baseline (day 0, first dose), after 3 weeks (second dose), four weeks post-second dose, at the time of the third dose administration and 4 weeks post-third dose. Seropositivity was defined as IgG ≥15 antibody-binding units (BAU)/mL. Data on vaccine safety were also collected by interview at each visit.ResultsA statistically significant increase in antibody titers was observed after each dose of vaccine compared with baseline, with no significant differences between patients and controls. Methotrexate used in combination with biologics has been shown to negatively influence the antibody response to the vaccine. On the contrary, increasing body mass index (BMI) positively influenced the antibody response. No adverse effects were reported, and no relapses of psoriasis were observed in the weeks following vaccine administration in our study population.ConclusionsOur data are largely consistent with the recent literature on this topic confirming the substantial efficacy and safety of BNT162b2 mRNA vaccine on psoriatic patients treated with biologics of different types and support the recommendation to perform additional doses in this specific subgroup of patients.

COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study

“…The authors reported that all patients showed seroconversion after completed vaccination consisting of two doses, which fits in well with our findings (44,49). Other studies also presented similar findings (50)(51)(52)(53)(54)(55)(56). The main results of other studies that also investigated the serological response to COVID-19 vaccination in psoriasis patients are summarized in Table 4 Two of three patients without seroconversion received MTX.…”

Immunogenicity, Effectiveness, and Safety of COVID-19 Vaccines among Patients with Immune-Mediated Dermatological Diseases: A Systematic Review and Meta-analysis

“…There were no studies of protein subunit vaccine users that were eligible. One study was excluded from the quantitative analysis due to the use of geometric mean concentration of anti-SARS-CoV-2 spike protein IgG as a representative of the immune response ( 24 ). Table I summarizes characteristics of the included studies.…”

Serum vitamin D levels can be predictive of psoriasis flares up after COVID-19 vaccination: a retrospective case control study

“…The withdraw of immunosuppressive treatment before and after receiving the vaccine was a tactic which is used to improve the efficacy of the vaccination immunity response. Currently, patients with psoriasis are recommended to receive COVID-19 vaccinations while continuing their biological treatment, and some patients may need a three-dose schedule to achieve sufficient levels of neutralizing antibodies against SARS-CoV-2 ( 31 ). Studies have shown that the second dose of BNT162b2 vaccine can effectively produce antibody responses in patients who are taking methotrexate and targeted biologics, but a lower percentage of immunosuppressed patients may have detectable T-cell responses after the second dose ( 32 ).…”