Spondyloarthritis & psoriatic arthritis
Effect of Secukinumab and Tumor Necrosis Factor Inhibitors on Humoral Response to BNT162b2 mRNA Vaccine in Patients With Spondyloarthritis Compared to Immunocompetent Controls
Authors' conclusion
SEC did not interfere with the immunogenic response to BNT162b2 vaccine in patients with SpA; however, TNFi therapy was associated with lower S1/S2-antibody titers, faster decline, and higher rate of breakthrough infections.
Study context
- Population
- Consecutive patients with PsA or axSpA receiving secukinumab (SEC) or tumor necrosis factor inhibitors (TNFi), immunocompetent controls and rheumatoid arthritis (RA) patients on TNFi, vaccinated with 2 or 3 doses of BNT162b2
- Participants
- 37 / 109 / 16 / 122 / 50
- Exposure
- SEC vs TNFi (monotherapy or + MTX) in spondyloarthritis (SpA), vs immunocompetent controls and RA patients receiving TNFi
- SECn = 37
- TNFi monotherapy-SpAn = 109
- TNFi + MTX-SpAn = 16
- Immunocompetentn = 122reference
- TNFi-RAn = 50
- Outcome
- Humoral response to BNT162b2 mRNA vaccine
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
S1/S2 antibody titers (BAU/mL) after 2-dose regimen
SEC vs TNFi + MTX-SpA: P < 0.001 · SEC vs TNFi-RA: P = 0.004
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| Remained seropositive · 6 monthsTNFi monotherapy-SpA vs Immunocompetent · SEC, immunocompetent and TNFi monotherapy-SpA | SEC 96.3% · Immunocompetent 96.6% · TNFi monotherapy-SpA 80.9% · TNFi + MTX-SpA 66.7% · TNFi-RA 63% | P = 0.10 |
| Remained seropositive · 6 monthsTNFi + MTX-SpA vs Immunocompetent | P = 0.03 | |
| Remained seropositive · 6 monthsTNFi-RA vs Immunocompetent | P = 0.004 | |
| Seropositive after third doseTNFi-RA vs Immunocompetent | TNFi-RA 88.9% | P = 0.25 |
| Breakthrough COVID-19 infection | SEC 10.8% |
- Breakthrough COVID-19 infection — Rate in TNFi groups
- 36-37.5%
Remained seropositive · 6 months
- S1/S2 antibody titer decline steeper in TNFi groups than SEC
Seropositive after third dose
- 100% of SpA and immunocompetent groups seropositive
Postvaccination disease activity
- No significant between-group differences
Safety
Adverse events
- No significant between-group differences
Original publication
Effect of Secukinumab and Tumor Necrosis Factor Inhibitors on Humoral Response to BNT162b2 mRNA Vaccine in Patients With Spondyloarthritis Compared to Immunocompetent Controls. J Rheumatol. Published 1 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →