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25-06-2021 | COVID-19 | News

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Study supports importance of second COVID-19 vaccine dose in DMARD-treated RA patients

Author: Claire Barnard


medwireNews: Rheumatoid arthritis (RA) patients are more likely than healthy controls to require both doses of vaccines against SARS-CoV-2 in order to mount an adequate immune response, researchers report.

As outlined in a comment published in The Lancet Rheumatology, 53 RA patients receiving continuous DMARD treatment had significantly lower median titers of antibodies against the SARS-CoV-2 spike protein than 20 healthy controls at 3 weeks after the first dose (0.4 vs 99.2 U/mL) and 2 weeks after the second dose (657 vs 2500 U/mL) of the Pfizer–BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccine.

When a titer of more than 15 U/mL was applied as the cutoff for an adequate response, just 10% of RA patients met this threshold after the first dose, compared with 90% of controls, a significant difference. This difference remained significant when a more stringent cutoff was used, with 2% of RA patients and 45% of controls having titers higher than 133 U/mL after the first dose.

After the second dose, 88% of RA patients had antibody titers higher than 15 U/mL and 82% had titers above 133 U/mL, while all individuals in the control group had titers above the higher cutoff.

“These data suggest that the kinetics of the vaccine-induced humoral immune response differs between patients with rheumatoid arthritis who are taking DMARDs and healthy individuals,” and highlight “the importance of a second vaccination” in RA patients, conclude Andrea Rubbert-Roth (Kantonsspital St Gallen, Switzerland) and colleagues.

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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Lancet Rheumatol 2021; doi: 10.1016/ S2665-9913(21)00186-7