Rituximab-treated rheumatic patients: B cells predict seroconversion after COVID-19 boost or revaccination in initial vaccine non-responders
Authors' conclusion
Continuously impaired humoral response to mRNA vaccines was found in most RTX-treated patients after a booster dose or revaccination. Seroconversion was observed in approximately one-third of the patients. Measurable B cells before boosting or revaccination was the strongest predictor of antibody response after boost or revaccination.
Study context
- Population
- Rituximab (RTX)-treated rheumatic disease (RD) patients previously vaccinated against COVID-19 who had not produced vaccine-reactive antibodies after the initial two vaccine doses
- Participants
- 91 participants
- Exposure
- Booster vaccine vs revaccination with an mRNA COVID-19 vaccine
- Outcome
- Seroconversion (serum total antibodies against SARS-CoV-2 spike protein)
- Follow-up
- 6 weeks after the last vaccine dose
Main finding
As reported in the abstract
Seroconversion in patients with undetectable SARS-CoV-2 antibodies before inclusion
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Antibody levelsSignificantly higher antibody levels with revaccination | P < 0.001 |
Predictors of seroconversion (logistic regression)
- B cells >10/µl before boost or revaccination associated with seroconversion, univariate
- P = 0.009
- B cells >10/µl before boost or revaccination associated with seroconversion, multivariate
- P = 0.01
- Seroconversion independent of age, gender, diagnosis, cumulative RTX dose, RTX treatment time and time since last RTX treatment
- Only B cells were associated with seroconversion
Original publication
Rituximab-treated rheumatic patients: B cells predict seroconversion after COVID-19 boost or revaccination in initial vaccine non-responders. Rheumatology (Oxford). Published 29 November 2022. doi:10.
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