Lupus & antiphospholipid syndrome
Immunogenicity and risk of disease flare after a three-dose regimen with SARS-CoV-2 vaccination in patients with systemic lupus erythematosus: results from the prospective cohort study COVAC-SLE
Authors' conclusion
A 3rd dose improved the humoral response to SARS-CoV-2 vaccines in patients with SLE to the level of healthy individuals. Vaccination did not affect SLE disease activity. Subsequent breakthrough infections were mild and did not require hospitalisation.
Study context
- Population
- Adult patients with systemic lupus erythematosus (SLE) receiving three doses of SARS-CoV-2 vaccines115 (93.5%) received BNT162b2
- Participants
- 123 patients
- Outcome
- Humoral immune response (SARS-CoV-2 spike IgG; sufficient response ≥54BAU/mL) and risk of disease flare
Main finding
As reported in the abstract
Sufficient antibody response after 3rd dose, n (%)
115
93.5%
Spike IgG after 3rd dose, median (IQR), BAU/mL
2416.9
1289–4603.8
Observational data: associations, not effects.
Further findings
Sufficient antibody response after 2nd dose
- Sufficient antibody response, n (%)
- 102 (83%)
- Spike IgG, median (IQR), BAU/mL
- 559.2 (288.8-1180.5)
Antibody levels by treatment, 8 weeks after 2nd dose · eight weeks after the 2nd dose
- Significantly lower antibodies with high dose prednisolone
- P = 0.034
- Significantly lower antibodies with DMARDs
- P < 0.001
- Difference not significant following the 3rd dose
Safety
Adverse events
- Adverse events more frequent in patients with a sufficient response
Breakthrough infections
- Breakthrough infections, n (%)
- 39 (31.7%)
- All with mild symptoms
Original publication
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