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

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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, Clinical Immunology and Allergology
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; Schietzel, Simeon; Horn, Michael; 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 and 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:

04 Apr 2022 09:22

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

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