Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring

Łukaszuk, Krzysztof; Wocławek-Potocka, Izabela; Jakiel, Grzegorz; Malinowska, Paulina; Wdowiak, Artur; Rozanska, Karolina; Rąbalski, Łukasz

doi:10.3390/vaccines9101151

Cited by 5 publications

(8 citation statements)

References 18 publications

(26 reference statements)

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“…We did not observe Methotrexate as an obstacle for obtaining an optimal medium-term response to mRNA vaccines. Discrepancies exists in previous studies evaluating the effect of this drug in the short-term response to vaccines 26 , 27 . In our series, no subject under Methotrexate had received Glucocorticoids and we did not detect a decrease in its nAB titre.…”

Section: Discussionmentioning

confidence: 99%

“…A poor humoral immune response has also been described for SLE patients treated with Glucocorticoids and immunosuppressive drugs after a single dose of mRNA vaccines 24 . SLE patients under Methotrexate or Mycophenolate-Mofetil regimes have also showed a lower antibody response against SARS-CoV-2 fifteen days after the second dose 25 , although current evidence about the effect of Methotrexate on humoral response is not consistent 26 , 27 . None of the works mentioned above evaluated nAB as a measure of response to the vaccine.…”

Section: Discussionmentioning

confidence: 99%

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Glucocorticoids’ treatment impairs the medium-term immunogenic response to SARS-CoV-2 mRNA vaccines in Systemic Lupus Erythematosus patients

Garcia-Cirera

Calvet

Berenguer‐Llergo

et al. 2022

Sci Rep

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Limited data exists on SARS-CoV-2 sustained-response to vaccine in patients with rheumatic diseases. This study aims to evaluate neutralizing antibodies (nAB) induced by SARS-CoV-2 vaccine after 3 to 6 months from administration in Systemic Lupus Erythematosus (SLE) patients, as a surrogate of sustained-immunological response. This cross-sectional study compared nAB titre of 39 SLE patients and 37 Healthy individuals with no previous SARS-CoV-2 infection, who had all received a complete regimen of a mRNA SARS-CoV-2 vaccine within the last 3 to 6 months. We included four lines of SLE treatment including Not-treated, Hydroxychloroquine, immunosuppressive drugs and biological therapy. Glucocorticoids were allowed in all groups. Healthy and Not-treated individuals showed the highest levels of nAB. Treated patients presented lower nAB titres compared to Healthy: a 73% decrease for First-Line patients, 56% for Second-Line treatment and 72% for Third-Line. A multivariate analysis pointed to Glucocorticoids as the most associated factor with declining nAB levels (75% decrease) in treated SLE. Furthermore, a significant reduction in nAB titres was observed for Rituximab-users compared to Healthy subjects (89% decrease). Medium-term response of SLE patients to SARS-CoV-2 mRNA vaccines is negatively impacted in Glucocorticoids and Rituximab users. These findings might help to inform recommendations in vaccination protocols for SLE patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glucocorticoids’ treatment impairs the medium-term immunogenic response to SARS-CoV-2 mRNA vaccines in Systemic Lupus Erythematosus patients

Garcia-Cirera

Calvet

Berenguer‐Llergo

et al. 2022

Sci Rep

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“…Haberman et al reported that patients with immune-mediated inflammatory diseases (IMIDs) on background MTX achieved anti-S antibodies production in only 62.2% of cases, whereas healthy subjects and patients with IMIDs on biologic treatments demonstrated robust antibody responses (over 90%) after primary vaccination (two doses, a 3-week interval) with the BNT162b2 mRNA COVID-19 vaccine [ 5 ]. Lukaszuk et al monitored anti-S antibody titers in a female patient with RA taking MTX and in 119 HCWs for 180 days after the second dose of the BNT162b2 mRNA COVID-19 vaccine using the same assay kit (Roche Elecsys Anti-SARS-CoV-2 S) that we used [ 7 ]. In this study, on the 8th day after the second vaccination dose, 68.1% of HCWs had results above 2500 U/mL, which is the upper detection limit of the assay set by Lukaszuk et al The participants whose results were detected within the upper limit had an average antibody titer of 1670.6 U/mL on day 8, 1319.0 U/mL (21% decrease) on day 14, and 845 U/mL (35% decrease) on day 30 after the second dose.…”

Section: Discussionmentioning

confidence: 99%

“…Lukaszuk et al continued to monitor anti-S antibody titers and reported that anti-S antibody titers gradually increased to a maximum of 3 months (203,7 U/mL), were maintained for up to 4 months (201.0 U/mL), and decreased slightly at 6 months (147.2 U/mL) after the second vaccination in patient with RA taking MTX [ 7 ]. In contrast, in HCWs, the anti-S antibody titers continued to decrease after the second vaccination.…”

Section: Discussionmentioning

confidence: 99%

Time Course of Antispike Antibody Titer after Administration of BNT162b2 mRNA COVID-19 Vaccine in a Patient with Rheumatoid Arthritis on Methotrexate

Shinohara

Hirose²

2023

Case Reports in Rheumatology

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Methotrexate, an anchor drug for rheumatoid arthritis, hinders the immunogenicity of mRNA COVID-19 vaccines. Therefore, an optimal vaccine strategy for patients with rheumatoid arthritis receiving methotrexate is vital. We monitored antispike antibody titers after BNT162b2 mRNA COVID-19 vaccination in seven healthcare workers and one methotrexate-treated rheumatoid arthritis patient. The antispike antibody titers of healthcare workers significantly increased immediately after primary vaccination and then continued to decrease, whereas those of the rheumatoid arthritis patient were significantly lower immediately after primary vaccination and then increased. The titers in all participants dramatically increased 1-month postbooster. These changes over time may suggest that in the methotrexate-treated rheumatoid arthritis patient, the generation of short-lived plasma cells was strongly suppressed; in contrast, the generation of long-lived plasma cells and memory B cells was intact. For methotrexate-treated rheumatoid arthritis patients, it is important to complete the primary and booster vaccination series to ensure sufficient immunity against COVID-19.

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“…al. [28] mRNA vaccine 126 patients with Li et al [36] CoronaVac, Lukaszuk et al [37] BNT162b2 vaccine (mRNA vaccine)…”

Section: Spinelli Etmentioning

confidence: 99%

Exploring the Safety and Effects of COVID-19 Vaccination in Patients with Autoimmune Disease

Vairavan¹,

Tan²,

Law³

et al. 2022

Prog Micobes Mol Biol

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The COVID-19 pandemic has quickly become the most significant public health phenomenon, effectively eclipsing the H1N1 and Ebola crises that came before it. It can spread rapidly and has caused the death and disability of many worldwide. Vaccines are our most effective line of defense against the rapidly spreading and mutating virion. Still, there is significant vaccine hesitancy among those with autoimmune conditions who fear the vaccine may cause them more harm than good. This scoping review explores the safety, outcomes, and effects of COVID-19 vaccines in autoimmune patients. Online databases; Pubmed, Ovid Medline, and Scopus were used to search published literature evaluating the effectiveness and side effects of COVID-19 vaccines in patients with autoimmune conditions. The search results were limited to 4 distinct autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, psoriasis, and myasthenia gravis). Thirty-seven studies were retrieved and assessed on the safety, effects, and outcomes of COVID-19 vaccination in patients with the chosen autoimmune conditions. Overall, the risk of flares and the development of severe side effects after vaccination was low. Most autoimmune patients showed a good antibody response to vaccination, especially after the second dose. This review provides a favorable impact of vaccination in patients with autoimmune conditions.

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Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring

Cited by 5 publications

References 18 publications

Glucocorticoids’ treatment impairs the medium-term immunogenic response to SARS-CoV-2 mRNA vaccines in Systemic Lupus Erythematosus patients

Glucocorticoids’ treatment impairs the medium-term immunogenic response to SARS-CoV-2 mRNA vaccines in Systemic Lupus Erythematosus patients

Time Course of Antispike Antibody Titer after Administration of BNT162b2 mRNA COVID-19 Vaccine in a Patient with Rheumatoid Arthritis on Methotrexate

Exploring the Safety and Effects of COVID-19 Vaccination in Patients with Autoimmune Disease

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