Trajectories of humoral and cellular immunity and responses to a third dose of mRNA vaccines against SARS-CoV-2 in patients with a history of anti-CD20 therapy.

Sidler, Daniel; Born, Alexander; Schietzel, Simeon; Horn, Michael P; Aeberli, Daniel; Amsler, Jennifer; Möller, Burkhard; Njue, Linet M; Medri, Cesare; Angelillo-Scherrer, Anne; Borradori, Luca; Jafari, S Morteza Seyed; Radonjic-Hoesli, Susanne; Chan, Andrew; Hoepner, Robert; Bacher, Ulrike; Mani, Laila-Yasmin; Iype, Joseena Mariam; Suter-Riniker, Franziska; Staehelin, Cornelia; ... (2022). Trajectories of humoral and cellular immunity and responses to a third dose of mRNA vaccines against SARS-CoV-2 in patients with a history of anti-CD20 therapy. RMD open, 8(1) BMJ Publishing Group 10.1136/rmdopen-2021-002166

[img]
Preview
Text
e002166.full.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (981kB) | Preview

BACKGROUND

The majority of patients with B-cell-depleting therapies show compromised vaccination-induced immune responses. Herein, we report on the trajectories of anti-SARS-CoV-2 immune responses in patients of the RituxiVac study compared with healthy volunteers and investigate the immunogenicity of a third vaccination in previously humoral non-responding patients.

METHODS

We investigated the humoral and cell-mediated immune response after SARS-CoV-2 messanger RNA vaccination in patients with a history with anti-CD20 therapies. Coprimary outcomes were antispike and SARS-CoV-2-stimulated interferon-γ concentrations in vaccine responders 4.3 months (median; IQR: 3.6-4.8 months) after first evaluation, and humoral and cell-mediated immunity (CMI) after a third vaccine dose in previous humoral non-responders. Immunity decay rates were compared using analysis of covariance in linear regression.

RESULTS

5.6 months (IQR: 5.1-6.7) after the second vaccination, we detected antispike IgG in 88% (29/33) and CMI in 44% (14/32) of patients with a humoral response after two-dose vaccination compared with 92% (24/26) healthy volunteers with antispike IgG and 69% (11/16) with CMI 6.8 months after the second vaccination (IQR: 6.0-7.1). Decay rates of antibody concentrations were comparable between patients and controls (p=0.70). In two-dose non-responders, a third SARS-CoV-2 vaccine elicited humoral responses in 19% (6/32) and CMI in 32% (10/31) participants.

CONCLUSION

This study reveals comparable immunity decay rates between patients with anti-CD20 treatments and healthy volunteers, but inefficient humoral or CMI after a third SARS-CoV-2 vaccine in most two-dose humoral non-responders calling for individually tailored vaccination strategies in this population.Trial registration numberNCT04877496; ClinicalTrials.gov number.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute for Immunology [discontinued]
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Sidler, Daniel (A), Schietzel, Simeon, Horn, Michael (B), Aeberli, Daniel, Amsler, Jennifer Susann, Möller, Burkhard, Njue, Linet Muthoni, Medri, Cesare, Angelillo, Anne, Borradori, Luca, Jafari, Morteza, Radonjic, Susanne Irene, Chan, Andrew Hao-Kuang, Hoepner, Robert, Bacher, Vera Ulrike, Mani, Laila-Yasmin, Iype, Joseena Mariam, Suter, Franziska Marta, Staehelin, Cornelia, Nagler, Michael, Hirzel, Cédric, Maurer, Britta, Moor, Matthias

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

2056-5933

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Pubmed Import

Date Deposited:

04 Apr 2022 09:13

Last Modified:

29 Mar 2023 23:38

Publisher DOI:

10.1136/rmdopen-2021-002166

PubMed ID:

35361691

Uncontrolled Keywords:

COVID-19 rituximab systemic vasculitis vaccination

BORIS DOI:

10.48350/168942

URI:

https://boris.unibe.ch/id/eprint/168942

Actions (login required)

Edit item Edit item
Provide Feedback