Impact of different classes of immune-modulating treatments on B cell-related and T cell-related immune response before and after COVID-19 booster vaccination in patients with immune-mediated diseases and primary immunodeficiency: a cohort study
Authors' conclusion
Patients with IMID on therapeutic B-cell depletion have low anti-S-AB and sVNT values before and after booster vaccination but show significantly higher levels of IGRA compared with other immunosuppressed patients, suggesting an underlying mechanism attempting to compensate compromised humoral immunity by upregulating T-cell responsiveness. PID appears to have a stronger impact on antiviral immune response than csDMARD/bDMARD treatment.
Study context
- Population
- Immunosuppressed patients (PID, or immune-mediated inflammatory diseases (IMIDs) on rituximab (RTX) or conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)/bDMARDs) receiving a COVID-19 booster (third) vaccination
- Participants
- 50 patients
- Exposure
- PID vs IMIDs on RTX vs IMIDs on csDMARDs/bDMARDs
- PIDn = 6
- RTXn = 13
- csDMARD/bDMARDn = 31
- Outcome
- B-cell (anti-spike IgG antibody, sVNT) and T-cell (IGRA) responses to COVID-19 booster vaccination
- Follow-up
- Before and 2, 4 and 8 weeks after booster
Main finding
As reported in the abstract
B-cell and T-cell responses to booster vaccination
- At baseline, anti-S-AB titres in PID and csDMARD/bDMARD-treated patients low but significantly higher than RTX; B-cell responses increased significantly after booster
- RTX: low baseline anti-S-AB and surrogate virus neutralisation test (sVNT) did not improve after booster, but significantly elevated interferon gamma release assay (IGRA) responses post booster vs other groups
- csDMARD/bDMARD: highest baseline values in all three assays, with greater increases in all parameters after booster vs PID
Observational data: associations, not effects.
Original publication
Impact of different classes of immune-modulating treatments on B cell-related and T cell-related immune response before and after COVID-19 booster vaccination in patients with immune-mediated diseases and primary immunodeficiency: a cohort study. RMD Open. Published 31 August 2023. doi:10.
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