Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases

Abstract

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases

“…Early data in this setting are largely consistent with that from other vaccine studies. Data suggest that rituximab, [80][81][82][83][84] glucocorticoids, 82 84 MTX, 82 84 85 abatacept, 84 mycophenolate mofetil 84 and JAK inhibitors 82 impair SARS-CoV-2 vaccine responses in many patients. The mRNA vaccine mechanism and potential impact of DMARD therapy is described in figure 1.…”

SARS-CoV-2 infection after vaccination in patients with inflammatory rheumatic and musculoskeletal diseases

“…1 2 Some common rheumatic and musculoskeletal disease (RMD) medications have been highlighted as possible influential factors on immunogenicity, particularly rituximab (RTX), mycophenolate mofetil (MMF), methotrexate (MTX), abatacept and glucocorticoids. [3][4][5][6][7] The European Alliance of Associations for Rheumatology (EULAR) launched a COVID-19 registry in March 2020, capturing COVID-19 outcomes in the European RMD population. Questions on reinfection and vaccination were added in January 2021.…”

Aktualisierte Handlungsempfehlungen der Deutschen Gesellschaft für Rheumatologie für die Betreuung von Patienten mit entzündlich-rheumatischen Erkrankungen im Rahmen der SARS-CoV‑2/COVID‑19-Pandemie einschließlich Empfehlungen zur COVID‑19-Impfung

“…Für RTX konnte in einer Untersuchung mit 5 Patienten [73] und in einer weiteren mit 30 Patienten [74] gezeigt werden, dass die Antikörperbildung nach COVID-19-Impfung in Abhängigkeit vom Abstand zur letzten Gabe von RTX deutlich unterdrückt wird. Dabei blieb eine antigenspezifische T-Zell-Antwort aber meist vorhanden.…”