Adaptive immune responses to SARS-CoV-2 in DMARD-treated patients with chronic inflammatory rheumatisms
Authors' conclusion
While most patients demonstrated the capacity to mount an immune response to SARS-CoV-2, treatment with RTX impacted both humoral and CD8+cell responses.
Study context
- Population
- Patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) on immunomodulatory therapies with confirmed SARS-CoV-2 infection (mean age 53±14 years)94 patients · 20 controls
- Exposure
- DMARD treatment groups (incl. RTX) vs other treatment groups and age-matched household contacts
- Methotrexate (MTX)/sulfasalazinen = 17/2
- anti-TNFn = 24
- anti-TNF+MTXn = 23
- RTXn = 11
- anti-IL17n = 7
- Othersn = 11
- Controlsn = 20reference
- Outcome
- Viral loads (plasma, stools, nasal swabs) and SARS-CoV-2-specific humoral and cellular immune responses (antibodies, B and T lymphocytes) following infection
Methodological detailsage-matched controls (household contacts)
- Age-matched controls (household contacts)
Main finding
As reported in the abstract
- Viral persistence not observed in blood, nasopharynx and stools of patients on immunomodulatory therapies (ITs)
- Overall, SARS-CoV-2-specific humoral and T-cell responses preserved
- RTX: significantly lower IgA and IgG responses vs other treatment groups
- Most patients, incl. RTX recipients, had significant CD4+ T cell responses
- RTX associated with reduced SARS-CoV-2-specific activated CD8+ T cells
- Correlation between humoral immune parameters and CD8+ T cell activation
Observational data: associations, not effects.
Original publication
Adaptive immune responses to SARS-CoV-2 in DMARD-treated patients with chronic inflammatory rheumatisms. RMD Open. Published 5 July 2025. doi:10.
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