PT  - JOURNAL ARTICLE
AU  - Carolina A.  Isnardi
AU  - Osvaldo L.  Cerda
AU  - Margarita Landi
AU  - Leonel Cruces
AU  - Emilce E.  Schneeberger
AU  - Claudia Calle Montoro
AU  - María Agustina  Alfaro
AU  - Brian M.  Roldán
AU  - Andrea B. Gómez Vara
AU  - Pamela Giorgis
AU  - Roberto Alejandro  Ezquer
AU  - María G. Crespo Rocha
AU  - Camila R. Reyes Gómez
AU  - Mária de los Ángeles Correa
AU  - Marcos G.  Rosemffet
AU  - Virginia Carrizo  Abarza
AU  - Santiago Catalan Pellet
AU  - Miguel Perandones
AU  - Cecilia Reimundes
AU  - Yesica Longueira
AU  - Gabriela Turk
AU  - María Florencia  Quiroga
AU  - Natalia Laufer
AU  - Rosana Quintana
AU  - María Celina  de la Vega
AU  - Nicolás Kreplak
AU  - Marina Pifano
AU  - Pablo Maid
AU  - Guillermo J.  Pons-Estel
AU  - Gustavo Citera
TI  - Immune Response to SARS-CoV-2 Third Vaccine in Patients With Rheumatoid Arthritis Who Had No Seroconversion After Primary 2-Dose Regimen With Inactivated or Vector-Based Vaccines
AID  - 10.3899/jrheum.220469
DP  - 2022 Oct 01
TA  - The Journal of Rheumatology
PG  - jrheum.220469
4099  - http://www.jrheum.org/content/early/2022/09/15/jrheum.220469.short
4100  - http://www.jrheum.org/content/early/2022/09/15/jrheum.220469.full
AB  - Objective The aim of this study was to assess the immune response after a third dose of SARS-CoV-2 vaccine in patients with rheumatoid arthritis (RA) with undetectable antibody titers after the primary regimen of 2 doses. Methods Patients with RA with no seroconversion after 2 doses of SARS-CoV-2 vaccine and who received a third dose of either an mRNA or vector-based vaccine were included. Anti-SARS-CoV-2 IgG antibodies, neutralizing activity, and T cell responses were assessed after the third dose. Results A total of 21 nonresponder patients were included. At the time of vaccination, 29% were receiving glucocorticoids and 85% biologic disease-modifying antirheumatic drugs (including 6 taking abatacept [ABA] and 4 taking rituximab [RTX]). The majority (95%) received the BNT162b2 vaccine and only one of them received the ChAdOx1 nCoV-19 vaccine. After the third dose, 91% of the patients presented detectable anti-SARS-CoV-2 IgG and 76% showed neutralizing activity. Compared to other treatments, ABA and RTX were associated with the absence of neutralizing activity in 4 out of 5 (80%) patients and lower titers of neutralizing antibodies (median 3, IQR 0-20 vs 8, IQR 4-128; P = 0.20). Specific T cell response was detected in 41% of all patients after the second dose, increasing to 71% after the third dose. The use of ABA was associated with a lower frequency of T cell response (33% vs 87%, P = 0.03). Conclusion In this RA cohort, 91% of patients who failed to seroconvert after 2 doses of SARS-CoV-2 vaccine presented detectable anti-SARS-CoV-2 IgG after a third dose. The use of ABA was associated with a lower frequency of specific T cell response.