RT Journal Article
SR Electronic
T1 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
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.220469
DO 10.3899/jrheum.220469
A1 Carolina A.  Isnardi
A1 Osvaldo L.  Cerda
A1 Margarita Landi
A1 Leonel Cruces
A1 Emilce E.  Schneeberger
A1 Claudia Calle Montoro
A1 María Agustina  Alfaro
A1 Brian M.  Roldán
A1 Andrea B. Gómez Vara
A1 Pamela Giorgis
A1 Roberto Alejandro  Ezquer
A1 María G. Crespo Rocha
A1 Camila R. Reyes Gómez
A1 Mária de los Ángeles Correa
A1 Marcos G.  Rosemffet
A1 Virginia Carrizo  Abarza
A1 Santiago Catalan Pellet
A1 Miguel Perandones
A1 Cecilia Reimundes
A1 Yesica Longueira
A1 Gabriela Turk
A1 María Florencia  Quiroga
A1 Natalia Laufer
A1 Rosana Quintana
A1 María Celina  de la Vega
A1 Nicolás Kreplak
A1 Marina Pifano
A1 Pablo Maid
A1 Guillermo J.  Pons-Estel
A1 Gustavo Citera
YR 2022
UL http://www.jrheum.org/content/early/2022/09/15/jrheum.220469.abstract
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.