Discontinuation of mycophenolate mofetil for at least 10 days is associated with an improved antibody response to COVID-19 vaccination among people with rheumatic diseases, research suggests.

The most common diagnosis was rheumatoid arthritis (49%), followed by anti-neutrophil cytoplasm antibody-associated vasculitis (30%), other vasculitis (9%), Sjögren’s syndrome (5%), and systemic lupus erythematosus (2%).

medwireNews : Results from a retrospective analysis suggest that cytomegalovirus (CMV) seropositivity at anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis diagnosis is an independent risk factor for developing venous thromboembolism (VTE).

She explained that ani-SARS-CoV-2 antibody responses typically wane after a booster vaccine, so slowing this process is “a very, very encouraging outcome for these patients because it means they’ve got a sustained boosting response.”

Pausing methotrexate only after the second dose of a COVID-19 vaccine may provide the best balance between antibody response and risk for flare, findings from two randomized controlled trials suggest.

The researchers note that 153 patients who had a weak antibody response to two vaccine doses (anti-RBD <100 AU/mL) were given a third dose at a median of 70 days after the second dose, and 84% of these people achieved an increase in antibody levels, with a median improvement of 362 AU/mL.

Antibody titers in the children ranged from 1 in 200 to 1 in 800 and all but one patient had exclusively immunoglobulin (Ig)G antibodies; the other also had IgM antibodies.

Findings from a phase 2b trial suggest that treatment with the anti-CD52 antibody alemtuzumab may be beneficial for some patients with primary systemic vasculitis and an inadequate response to conventional therapies.

Findings from the CoronavRheum trial suggest that suspension of methotrexate for 2 weeks after each dose of the Sinovac inactivated SARS-CoV-2 vaccine may improve antibody response rates to vaccination among people with rheumatoid arthritis.

Antibody nonresponse, receipt of the Bharat Biotech Covaxin vaccine, and mycophenolate mofetil use were all significantly associated with breakthrough infection risk on univariate analysis.

Classifying individuals with musculoskeletal symptoms and no clinical synovitis using anti-cyclic citrullinated peptide antibody levels and self-reported hand or foot pain may be useful to prioritize rheumatology referrals, study findings indicate.

However, mean antibody levels were significantly lower among the adolescents with rheumatic diseases than controls, at 242.0 versus 387.8 binding antibody units/mL.

The antibody response rate to vaccination (predominantly two doses) across the studies ranged from 0% to 80%, with a pooled response rate of 40%.

Despite this drop in antibody levels, 96% of participants had positive anti-spike titers (≥0.8 units/mL) at 6 months, while 80% had a high-positive response (≥50 units/mL), defined on the basis of neutralizing capacity determined in people with convalescent COVID-19 and in a previous modeling study.

The patient numbers in the development datasets ranged from 107 to 578, while the comparator groups – involving people with other forms of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and other small- and medium-vessel vasculitidies – included between 408 and 652 patients.

The updated recommendations also endorse the use of monoclonal antibody therapy as pre- and post-exposure prophylaxis, or as treatment for newly symptomatic individuals with COVID-19, for high-risk RMD patients if licensed and available. medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group 3 February 2022: The coronavirus pandemic is affecting all healthcare professionals across the globe.

And it pretty well flattens the antibody response to immunization.

A third dose of the Pfizer–BioNTech vaccine gives rise to a neutralizing antibody response in the majority of people with ANCA-associated vasculitis, but those treated with rituximab are unlikely to respond, researchers report.

The overall seroconversion rate across the two groups was 27%, with a median anti-SARS-CoV-2 antibody concentration of 15.7 binding antibody units/mL.

Findings from two studies suggest that among rituximab-treated patients, those with a longer time since their last infusion may be more likely to have an antibody response to vaccines against SARS-CoV-2.