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11-05-2021 | COVID-19 | News

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Rituximab treatment ‘may not preclude’ COVID-19 vaccination

Author: Claire Barnard


medwireNews: Findings from a small study suggest that rituximab-treated patients with depleted B cells may be able to mount a T cell-mediated immune response to COVID-19 vaccination, despite having an impaired antibody response.

Daniel Aletaha (Medical University of Vienna, Austria) and team evaluated the humoral and cell-mediated response to the Pfizer–BioNTech (BNT162b2) vaccine in five patients with immune-mediated diseases who had their last rituximab infusion 4–12 months prior to vaccination. They report that three of these people did not have detectable CD19+ B cells and did not develop an antibody response against the SARS-CoV-2 receptor binding domain, whereas two patients had CD19+ B cells and had a positive antibody response, “suggesting the development of a humoral immune response once peripheral B cells are repopulated.”

Despite the diminished humoral immune response in patients with depleted B cells, Aletaha et al say that an interferon-γ response to SARS-CoV-2 peptides, indicating T cell reactivity, was detected in the rituximab-treated patients, irrespective of the antibody response.

These findings suggest that treatment with rituximab “may not have to preclude SARS-CoV-2 vaccination, since a cellular immune response will be mounted even in the absence of circulating B cells,” write the researchers in a letter to the Annals of the Rheumatic Diseases.

They conclude: “It will be important to understand if T cell immunity is important or possibly even sufficient to protect patients against infection with the virus on vaccination.”

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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Ann Rheum Dis 2021; doi:10.1136/annrheumdis-2021-220408