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14-02-2022 | COVID-19 | News

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

Author: Claire Barnard

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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

14 February 2022: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.

RMD Open 2022; 8: e002036

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