Studies are urgently needed to characterize immunogenicity, efficacy, and safety of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) mRNA vaccines in kidney transplant (KT) recipients, excluded from major clinical trials. Complex ELISPOT and other cellular response techniques have been applied, but simpler tools are needed. An easy‐to‐use real‐world monitoring of SARS‐CoV‐2 IgG antibodies against the Spike protein and QuantiFERON ® SARS‐CoV‐2 IFNγ release assay (IGRA) were performed at baseline and 28 days after the second dose in KT recipients and controls (dialysis patients and healthy ones). All healthy controls and >95% dialysis controls became positive for anti‐S IgG antibodies, while only 63.3% of KT patients seroconverted with a very low antibody level. A positive IGRA was documented in 96.9% of controls, 89.3% peritoneal dialysis, 77.6% hemodialysis, 61.3% of KT patients transplanted more than 1 year ago and only 36% of those transplanted within the previous 12 months. Overall, 100% of healthy controls, 95.4% of dialysis patients and 78.8% KT recipients developed any immune response (humoral and/or cellular) against SARS‐CoV‐2. KT patients showed low rates of immune responses to mRNA Coronavirus infectious disease 2019 vaccines, especially those with recent transplantations. Simple humoral and cellular monitoring is advisable, so that repeated doses may be scheduled according to the results.

Background and importance Patient adherence is a key determinant of treatment success in rheumatological immunomediated diseases. Available data about adherence to biological treatments and factors associated with non-adherence are limited in Spain. Moreover, no studies have compared adherence between subcutaneous and oral drugs. Aim and objectives To evaluate non-adherence to prescribed subcutaneous biologicals and oral drugs in patients with rheumatological immunomediated diseases and to assess possible predictor factors associated with treatment non-adherence. Material and methods A retrospective observational study was conducted in all patients receiving oral and subcutaneous treatment for rheumatological immune mediated diseases from 2017 to 2019 in the outpatient pharmaceutical care area of a tertiary university hospital. Non-adherence was evaluated by reviewing all scheduled drug dispensing visits in the computerised application. We considered non-adherent every time that a patient missed at least one drug administration. Data collected were demographic, total patients and patient treatments, total dispensing visits and route of administration for the drug dispensed in every visit. We classified patients as adherent and non-adherent considering the number of dispensing visits. In the non-adherent group, we recorded the number of dispensing visits, reasons for non-adherence, number of missed administrations per patient, and drug and predictor factors for non-adherence. Results 783 patients were included, aged 52.4 (13.7) years, 427 (54.5%) were women, 164 (20.9%) were smokers and 697 (89%) were Caucasian. 79 (10.1%) of 783 patients received more than one treatment. There were 869 patient treatments: 294 adalimumab (33.8%), 236 etanercept (27.2%), 78 golimumab (8.9%), 47 apremilast (5.4%), 39 certolizumab (4.5%), 34 secukinumab (3.9%) and 30 tocilizumab (3.5%). There were 9197 dispensing visits. Route of administration was 6406 subcutaneous (93.2%) and 374 oral (6.8%). Non-adherence analysis 2417 (26.3%) dispensing visits, reasons for non-adherence/dispensing visits: 92 unjustified (97.5%), 33 infection (1.4%), 18 surgery (0.7%), 3 pregnancy (0.1%), 6 other (0.3%). Number of missed administrations/ patient treatments: 675 patients missed at least one administration (77.7%), mean 2.5 (±12.9) missed administrations. Number of missed administrations/drug: 9.9 baricitinib (±20.8), 15.8 tofacitinib (±31.2) and 25.4 apremilast (±53.2). Predictor factors for non-adherence: ethnicity (p=0.015), treatment with golimumab (p=0.006) and tocilizumab (p=0.036) and age (p=0.072). Conclusion and relevance Non-adherence to the prescribed drug occurred in 77.7% of patients with rheumatological immune mediated diseases. Demographic factors such as ethnicity as well as golimumab and tocilizumab treatment, despite their different frequency of administration, were predictors for non-adherence. Route of administration did not influence nonadherence.

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Background and Importance Biologic therapies (BT) used in psoriasis are hospital restricted dispensation medications. Lately, telepharmacy procedures, including non-face-to-face dispensation had become more common. Aim and Objectives To analyse if a telepharmacy programme (dispensation through community pharmacies (DTCP) and follow-up pharmacist-teleconsultations) can improve adherence and clinical outcomes in a cohort of patients with psoriasis receiving BT. Material and Methods Patients with psoriasis on stable BT were offered to enter a telepharmacy programme in February 2020 in the Pharmacy Outpatients Area of a tertiary hospital. The programme consisted in DTCP accompanied with followup pharmacist teleconsultations.Patients included in the study must had been in stable treatment for at least one year before entering this programme ('previous period', February 2019-February 2020) and stay for 6 months ('later period').Adherence (Medication Possession Ratio) and clinical variables (Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI)) were assessed during both periods. In the 'later period' adherence to BT dispensed through community pharmacies was confirmed with patients by pharmacist teleconsultations.Differences between adherence and clinical outcomes were evaluated in both periods as well as variables associated with an improvement in adherence. Quantitative data expressed as frequency and qualitative data as median (IQR). Results Of 221 patients, 99(44,8%) accepted to enter the programme. Of them, 45 (45,5%) were excluded: change of treatment 32 (14,5%), BT for less than 1 year 12 (5,4%) and loss of follow-up 7(3,2%).