Type of mRNA COVID-19 vaccine and immunomodulatory treatment influence humoral immunogenicity in patients with inflammatory rheumatic diseases

CE Raptis, CT Berger, A Ciurea, DO Andrey, C Polysopoulos, P Lescuyer, T Maletic, M Riek, A Scherer, I von Loga, J Safford, K Lauper, B Möller, N Vuilleumier, A Finckh, A Rubbert-Roth

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with inflammatory rheumatic diseases (IRD) are at increased risk for worse COVID-19 outcomes. Identifying whether mRNA vaccines differ in immunogenicity and examining the effects of immunomodulatory treatments may support COVID-19 vaccination strategies. We aimed to conduct a long-term, model-based comparison of the humoral immunogenicity following BNT162b2 and mRNA-1273 vaccination in a cohort of IRD patients. Patients from the Swiss IRD cohort (SCQM), who assented to mRNA COVID-19 vaccination were recruited between 3/2021-9/2021. Blood samples at baseline, 4, 12, and 24 weeks post second vaccine dose were tested for anti-SARS-CoV-2 spike IgG (anti-S1). We examined differences in antibody levels depending on the vaccine and treatment at baseline while adjusting for age, disease, and past SARS-CoV-2 infection. 565 IRD patients provided eligible samples. Among monotherapies, rituximab, abatacept, JAKi, and TNFi had the highest odds of reduced anti-S1 responses compared to no medication. Patients on specific combination therapies showed significantly lower antibody responses than those on monotherapy. Irrespective of the disease, treatment, and past SARS-CoV-2 infection, the odds of higher antibody levels at 4, 12, and 24 weeks post second vaccine dose were, respectively, 3.4, 3.8, and 3.8 times higher with mRNA-1273 versus BNT162b2 (p < 0.0001). With every year of age, the odds ratio of higher peak humoral immunogenicity following mRNA-1273 versus BNT162b2 increased by 5% (p < 0.001), indicating a particular benefit for elderly patients. Our results suggest that in IRD patients, two-dose vaccination with mRNA-1273 versus BNT162b2 results in higher anti-S1 levels, even more so in elderly patients.

Original languageEnglish
Article number1016927
Number of pages11
JournalFrontiers in Immunology
Volume13
DOIs
Publication statusPublished - 13 Oct 2022

Keywords

  • BNT162b2
  • SARS-CoV-2
  • Anti-spike-IgG
  • Immunosuppression
  • MRNA-1273
  • Rheumatic disease
  • Vaccination
  • Waning immunity
  • anti-spike-IgG
  • immunosuppression
  • mRNA-1273
  • waning immunity
  • rheumatic disease
  • vaccination
  • Rheumatic Diseases/drug therapy
  • Humans
  • Immunoglobulin G
  • Antibodies, Viral
  • RNA, Messenger/genetics
  • BNT162 Vaccine
  • COVID-19 Vaccines
  • Viral Vaccines
  • COVID-19/prevention & control
  • Aged

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