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14-02-2022 | COVID-19 | News

News in brief

Meta-analysis confirms negative impact of rituximab on COVID-19 vaccine response

Author: Claire Barnard


medwireNews: Findings from a systematic review and meta-analysis indicate that patients treated with anti-CD20 therapies have a heterogeneous response to vaccines against SARS-CoV-2, with particularly low seroconversion rates among those with recent B-cell depletion.

The meta-analysis included 23 studies involving a total of 1342 patients treated with anti-CD20 therapy (rituximab, ocrelizumab, obinutuzumab, ofatumumab, or ibritumomab tiuxetan) for conditions including rheumatic diseases, multiple sclerosis, kidney transplantation, and cancer. The antibody response rate to vaccination (predominantly two doses) across the studies ranged from 0% to 80%, with a pooled response rate of 40%.

Response rates were lower in patients with an interval of less versus more than 6 months since their last anti-CD20 therapy (20 vs 63%). Similarly, patients with depleted B-cell numbers had lower response rates than those with repopulated B cells (20 vs 77%).

The team says that pooled humoral response rates were similar among people with autoimmune diseases and those with cancer (43 vs 36%), but “markedly lower” in kidney transplant recipients (14%).

Based on these findings, “we recommend a close assessment of vaccine-induced seroconversion in patients on anti-CD20 therapy for consideration of additional doses of SARS-CoV-2 vaccine,” write Matthias Moor (Inselspital University Hospital Bern, Switzerland) and colleagues in RMD Open.

They continue: “This is most crucial in those within 6 months since the last dose of anti-CD20 therapy, in those with currently low circulating B cell counts and in transplant recipients treated with multiple immunosuppressive comedications.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

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RMD Open 2022; 8: e002036