RT Journal Article
SR Electronic
T1 Importance of the second SARS-CoV-2 vaccination dose for achieving serological response in patients with rheumatoid arthritis and seronegative spondyloarthritis
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 416
OP 421
DO 10.1136/annrheumdis-2021-221347
VO 81
IS 3
A1 Elisabeth Simader
A1 Selma Tobudic
A1 Peter Mandl
A1 Helmuth Haslacher
A1 Thomas Perkmann
A1 Thomas Nothnagl
A1 Judith Sautner
A1 Helga Radner
A1 Florian Winkler
A1 Heinz Burgmann
A1 Daniel Mrak
A1 Daniel Aletaha
A1 Stefan Winkler
A1 Stephan Blüml
YR 2022
UL http://ard.bmj.com/content/81/3/416.abstract
AB Objectives To assess the kinetics of humoral response after the first and second dose of messenger RNA (mRNA) vaccines in patients with inflammatory joint diseases compared with healthy controls (HC). To analyse factors influencing the quantity of the immune response.Methods We enrolled patients with rheumatoid arthritis (RA) and seronegative spondyloarthritis (SpA), excluding those receiving B-cell depleting therapies and assessed the humoral response to mRNA vaccines after the first and the second dose of the vaccine in terms of seroconversion rate and titre. We compared the results to a HC group and analysed the influence of therapies as well as other characteristics on the humoral response.Results Samples from 53 patients with RA, 46 patients with SpA and 169 healthy participants were analysed. Seroconversion rates after the first immunisation were only 54% in patients with inflammatory arthritis compared with 98% in the HC group. However, seroconversion rates were 100% in all groups after second immunisation. Patients developed reduced antibody titres after the first vaccination compared with HC, but there was no difference after the second dose. While disease modifying anti-rheumatic drug (DMARD) monotherapy did not affect antibody levels, seroconversion rates as well as titre levels were reduced in patients receiving a combination of DMARDs compared with HC.Conclusions Patients with inflammatory joint diseases under DMARD therapy show impaired humoral responses to the first vaccine dose but excellent final responses to vaccination with mRNA vaccines. Therefore, the full course of two immunisations is necessary for efficient vaccination responses in patients with inflammatory arthritis under DMARD therapy.Data are available upon reasonable request. Not applicable.