Impact of rituximab on humoral response to COVID-19 booster vaccine and antibody kinetics in patients with anti–neutrophil cytoplasmic antibody vasculitis

Third COVID-19 vaccine dose with BNT162b2 in patients with ANCA-associated vasculitis

“…Notably, patients treated with rituximab had particularly low seroconversion rates6 7 without detectable neutralising antibody activity against B.1.617.2 in our study. In a first case series on a third vaccine dose in three patients with AAV treated with rituximab, the booster dose was only associated with detectable humoral response in one patient 8. In our study, no patient treated with rituximab in the last year showed neutralising activity against B.1.617.2 after a third vaccine dose.…”

“…In a first case series on a third vaccine dose in three patients with AAV treated with rituximab, the booster dose was only associated with detectable humoral response in one patient. 8 In our study, no patient treated with rituximab in the last year showed neutralising activity against B.1.617.2 after a third vaccine dose. However, in patients with AAV not treated with rituximab, a third mRNA vaccine dose resulted in significantly higher B.1.617.2 neutralisation compared with standard two-dose mRNA vaccination.…”

COVID-19 mRNA Vaccine in Patients With Lymphoid Malignancy or Anti-CD20 Antibody Therapy: A Systematic Review and Meta-Analysis

“… 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 28 articles were excluded with the following reasons: (1) insufficient data of outcomes, 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 (2) duplicate publications from an overlapping cohort, 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 and (3) case series or cohorts with < 10 patients. 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 A flow diagram of the article selection process is shown in Figure 1 , and the characteristics of each study are summarized in Table 1 .…”

Mandating COVID-19 vaccination prior to kidney transplantation in the United States: No solutions, only decisions

“…21 Additionally, some patients with advanced chronic kidney disease or end stage kidney disease are maintained on medications, such as mycophenolate mofetil or rituximab, which demonstrably reduced responsiveness to the COVID‐19 vaccine, and may require several vaccine doses to elicit clinically significant responsiveness (however defined). 22 , 23 No policy can be sufficiently granular to account for all clinical scenarios, but precision and specificity provides greater support to a center's arguments in favor of endorsing a requirement under the rubric of safe clinical practice. While is it probable that a hypo‐responsive vaccine recipient has more protection against severe COVID‐19 infection compared to no vaccination due to elicited T‐cell mediated immunity, centers with a vaccine mandate should specify whether the mandate requires that transplant candidates demonstrate threshold antibody titers (or some other validated surrogate measure of responsiveness) after vaccination, before deemed eligible to receive an organ offer.…”

“…Furthermore, there have been concerns raised regarding the reliability of clinical interpretations of both the presence and absence of post‐vaccine antibodies, as well as antibody titers 21 . Additionally, some patients with advanced chronic kidney disease or end stage kidney disease are maintained on medications, such as mycophenolate mofetil or rituximab, which demonstrably reduced responsiveness to the COVID‐19 vaccine, and may require several vaccine doses to elicit clinically significant responsiveness (however defined) 22,23 . No policy can be sufficiently granular to account for all clinical scenarios, but precision and specificity provides greater support to a center's arguments in favor of endorsing a requirement under the rubric of safe clinical practice.…”