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03-11-2021 | COVID-19 | News

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‘Reassuring’ immunogenicity following two COVID-19 vaccine doses in people with giant cell arteritis

Author: Claire Barnard


medwireNews: The majority of patients with giant cell arteritis (GCA) generate an antibody response following both doses of the Pfizer–BioNTech (BNT162b2) COVID-19 vaccine, researchers report in a letter to Rheumatology.

These findings are based on an analysis of 48 patients with GCA who received both doses of the vaccine 3 weeks apart in April 2021. A total of 91.7% were taking glucocorticoids, while 35.4% were on methotrexate.

Paolo Delvino (University of Pavia, Italy) and team say that “reassuringly, almost all patients in our cohort achieved serological immunity after two vaccine doses,” with 93.8% testing positive for anti-SARS-CoV-2 immunoglobulin (Ig)G antibodies 3 weeks after the second dose, compared with 100% of a cohort of 140 healthy controls.

On the other hand, they found that immunogenicity after the first vaccine dose was “poor and significantly hampered by [glucocorticoids] and methotrexate,” with an IgG positivity rate of just 41.7% in the GCA group, compared with 94.2% for the healthy controls.

Multivariate analysis demonstrated that there was a significantly lower likelihood of developing antibodies after the first vaccine dose with use of glucocorticoids at a dose of at least 7.5 mg/day (odds ratio [OR]=0.667) or methotrexate (OR=0.521), whereas methotrexate use was the only significant predictor after the second dose (OR=0.849).

These findings show that “particular caution is warranted until the completion of the full vaccine schedule,” and provide “evidence to discourage the practice of delaying the second vaccine dose in immunocompromised patients,” conclude Delvino and team.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group

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Rheumatology 2021; doi:10.1093/rheumatology/keab77