Vasculitis & polymyalgia rheumatica
Immunosuppressive treatments selectively affect the humoral and cellular response to SARS-CoV-2 in vaccinated patients with vasculitis
Authors' conclusion
Although patients with GCA apparently achieve a robust antibody seroconversion, there is a significant impairment of the neutralizing activity. MTX significantly reduced all levels of the humoral response. Up to one-third of patients do not develop a cellular immune protection in response to COVID-19 vaccination.
Study context
- Population
- Patients with GCA receiving two doses of BNT162b2 mRNA COVID-19 vaccine56 GCA included, 44 eligible
- Participants
- 44 vs 51
- Exposure
- Patients with GCA vs healthy controls
- GCAn = 44
- HCn = 51reference
- Outcome
- Humoral (S-IgG, NtAb) and cellular (enzyme linked immunosorbent spot (ELISpot)) immune response to mRNA COVID-19 vaccine
- Follow-up
- 3 weeks from the second vaccine dose
Methodological detailsconsecutive patients, healthy controls
- Consecutive patients
- Healthy controls
Main finding
As reported in the abstract
Antibody (S-IgG) response · 3 weeks after second dose
P < 0.0001
Observational data: associations, not effects.
Further findings
Lack of cellular response
P < 0.0001
| Outcome | GCA | HC |
|---|---|---|
| Neutralizing activity not detected | 16% | — not stated in the abstract |
— not stated in the abstract
Antibody titres (S-IgG and neutralizing antibodies (NtAb))
- Significantly lower in GCA than HCs
Effect of treatments on immune response
- Humoral response (S-IgG and NtAb) significantly hampered by MTX
- Cellular response significantly influenced by baseline peripheral T-lymphocytes and GC treatment
- Tocilizumab did not affect any level of the immune response
Original publication
Immunosuppressive treatments selectively affect the humoral and cellular response to SARS-CoV-2 in vaccinated patients with vasculitis. Rheumatology (Oxford). Published 23 June 2022. doi:10.
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