Rituximab-treated rheumatic patients : B cells predict seroconversion after COVID-19 boost or revaccination in initial vaccine non-responders
© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVES: To investigate the effect of either a booster vaccine (one dose) or revaccination (two doses 3 weeks apart) on the antibody response to the COVID-19 mRNA vaccines in patients with rheumatic disease (RD) treated with rituximab (RTX) who had not produced vaccine-reactive antibodies after the initial two vaccine doses. Further, to examine if B cell levels in peripheral blood predicted seroconversion.
METHODS: We included 91 RTX-treated RD patients previously vaccinated against COVID-19. Patients were offered revaccination or a single booster vaccination with an mRNA vaccine. Serum total antibodies against SARS-CoV-2 spike protein were measured before and 6 weeks after the last vaccine dose. B cells (CD19+CD45+) were measured by flow cytometry at inclusion.
RESULTS: Of RD patients with undetectable SARS-CoV-2 antibody levels before inclusion, seroconversion was seen in 38% 6 weeks after the booster dose and 32% after revaccination. Patients receiving revaccination had significantly higher antibody levels than patients receiving a booster dose (P < 0.001). In both univariate and multivariate logistic regression analysis, only B cells higher than 10/µl before boost or revaccination were associated with seroconversion (P = 0.009 and P = 0.01, respectively). Seroconversion was independent of age, gender, diagnosis, cumulative RTX dose, RTX treatment time and time since last RTX treatment.
CONCLUSION: Continuously impaired humoral response to mRNA vaccines was found in most RTX-treated patients after a booster dose or revaccination. Seroconversion was observed in approximately one-third of the patients. Measurable B cells before boosting or revaccination was the strongest predictor of antibody response after boost or revaccination.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
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| Enthalten in: |
Rheumatology (Oxford, England) - 62(2023), 7 vom: 05. Juli, Seite 2544-2549 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ammitzbøll, Christian [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 07.07.2023 Date Revised 18.07.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/rheumatology/keac666 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM349578559 |
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| 100 | 1 | |a Ammitzbøll, Christian |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rituximab-treated rheumatic patients |b B cells predict seroconversion after COVID-19 boost or revaccination in initial vaccine non-responders |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 07.07.2023 | ||
| 500 | |a Date Revised 18.07.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVES: To investigate the effect of either a booster vaccine (one dose) or revaccination (two doses 3 weeks apart) on the antibody response to the COVID-19 mRNA vaccines in patients with rheumatic disease (RD) treated with rituximab (RTX) who had not produced vaccine-reactive antibodies after the initial two vaccine doses. Further, to examine if B cell levels in peripheral blood predicted seroconversion | ||
| 520 | |a METHODS: We included 91 RTX-treated RD patients previously vaccinated against COVID-19. Patients were offered revaccination or a single booster vaccination with an mRNA vaccine. Serum total antibodies against SARS-CoV-2 spike protein were measured before and 6 weeks after the last vaccine dose. B cells (CD19+CD45+) were measured by flow cytometry at inclusion | ||
| 520 | |a RESULTS: Of RD patients with undetectable SARS-CoV-2 antibody levels before inclusion, seroconversion was seen in 38% 6 weeks after the booster dose and 32% after revaccination. Patients receiving revaccination had significantly higher antibody levels than patients receiving a booster dose (P < 0.001). In both univariate and multivariate logistic regression analysis, only B cells higher than 10/µl before boost or revaccination were associated with seroconversion (P = 0.009 and P = 0.01, respectively). Seroconversion was independent of age, gender, diagnosis, cumulative RTX dose, RTX treatment time and time since last RTX treatment | ||
| 520 | |a CONCLUSION: Continuously impaired humoral response to mRNA vaccines was found in most RTX-treated patients after a booster dose or revaccination. Seroconversion was observed in approximately one-third of the patients. Measurable B cells before boosting or revaccination was the strongest predictor of antibody response after boost or revaccination | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a B cell depleting therapy | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a autoimmune disease | |
| 650 | 4 | |a mRNA vaccine | |
| 650 | 4 | |a pandemic | |
| 650 | 4 | |a rheumatic diseases | |
| 650 | 4 | |a rituximab | |
| 650 | 4 | |a vaccine | |
| 650 | 4 | |a vaccine recommendation | |
| 650 | 4 | |a vaccine response | |
| 650 | 7 | |a spike protein, SARS-CoV-2 |2 NLM | |
| 650 | 7 | |a Rituximab |2 NLM | |
| 650 | 7 | |a 4F4X42SYQ6 |2 NLM | |
| 650 | 7 | |a Vaccines |2 NLM | |
| 650 | 7 | |a Antibodies, Viral |2 NLM | |
| 700 | 1 | |a Kragh Thomsen, Marianne |e verfasserin |4 aut | |
| 700 | 1 | |a Bøgh Andersen, Jakob |e verfasserin |4 aut | |
| 700 | 1 | |a Jensen, Jens Magnus Berth |e verfasserin |4 aut | |
| 700 | 1 | |a From Hermansen, Marie-Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Dahl Johannsen, Anders |e verfasserin |4 aut | |
| 700 | 1 | |a Larsen, Mads Lamm |e verfasserin |4 aut | |
| 700 | 1 | |a Mistegaard, Clara Elbæk |e verfasserin |4 aut | |
| 700 | 1 | |a Mikkelsen, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Szabados, Fruzsina |e verfasserin |4 aut | |
| 700 | 1 | |a Vils, Signe Risbøl |e verfasserin |4 aut | |
| 700 | 1 | |a Erikstrup, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Hauge, Ellen-Margrethe |e verfasserin |4 aut | |
| 700 | 1 | |a Troldborg, Anne |e verfasserin |4 aut | |
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