Evidence map›Paper›PMID 36844197›Full record

ArticleFrontiers in medicine2023

The accelerated waning of immunity and reduced effect of booster in patients treated with bDMARD and tsDMARD after SARS-CoV-2 mRNA vaccination.

Selma Tobudic, Elisabeth Simader, Thomas Deimel, Jennifer Straub, Felix Kartnig, Leonhard X Heinz, Peter Mandl, Helmuth Haslacher, Thomas Perkmann, Lisa Schneider and 10 more

Abstract read
In one paragraph

Article in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Selma TobudicDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Elisabeth SimaderDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Thomas DeimelDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Jennifer StraubDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Felix KartnigDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Leonhard X HeinzDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Peter MandlDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Helmuth HaslacherDepartment of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Thomas PerkmannDepartment of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Lisa SchneiderDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Thomas NothnaglDepartment of Second Medical, Lower Austrian Centre for Rheumatology, Korneuburg-Stockerau Hospital, Stockerau, Austria.
Helga RadnerDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Florian WinklerDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Heinz BurgmannDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Karin StiasnyCenter for Virology, Medical University of Vienna, Vienna, Austria.
Gottfried NovacekDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Walter ReinischDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Daniel AletahaDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Stefan WinklerDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Stephan BlümlDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: This study aimed to assess the duration of humoral responses after two doses of SARS-CoV-2 mRNA vaccines in patients with inflammatory joint diseases and IBD and booster vaccination compared with healthy controls. It also aimed to analyze factors influencing the quantity and quality of the immune response. Methods: We enrolled 41 patients with rheumatoid arthritis (RA), 35 with seronegative spondyloarthritis (SpA), and 41 suffering from inflammatory bowel disease (IBD), excluding those receiving B-cell-depleting therapies. We assessed total anti-SARS-CoV-2 spike antibodies (Abs) and neutralizing Ab titers 6 months after two and then after three doses of mRNA vaccines compared with healthy controls. We analyzed the influence of therapies on the humoral response. Results: Patients receiving biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) showed reduced anti-SARS-CoV-2 S Abs and neutralizing Ab titers compared with HC or patients receiving conventional synthetic (cs)DMARDs 6 months after the first two vaccination doses. Anti-SARS-CoV-2 S titers of patients with b/tsDMARDs declined more rapidly, leading to a significant reduction in the duration of vaccination-induced immunity after two doses of SARS-CoV-2 mRNA vaccines. While 23% of HC and 19% of patients receiving csDMARDs were without detectable neutralizing Abs 6 months after the first two vaccination doses, this number was 62% in patients receiving b/tsDMARDs and 52% in patients receiving a combination of csDMARDs and b/tsDMARDs. Booster vaccination led to increased anti-SARS-CoV-2 S Abs in all HC and patients. However, anti-SARS-CoV-2 S Abs after booster vaccination was diminished in patients receiving b/tsDMARDs, either alone or in combination with csDMARDs compared to HC. Conclusion: Patients receiving b/tsDMARDs have significantly reduced Abs and neutralizing Ab titers 6 months after mRNA vaccination against SARS-CoV-2. This was due to a faster decline in Ab levels, indicating a significantly reduced duration of vaccination-induced immunity compared with HC or patients receiving csDMARDs. In addition, they display a reduced response to a booster vaccination, warranting earlier booster vaccination strategies in patients under b/tsDMARD therapy, according to their specific Ab levels.

Indexed as

arthritisbDMARDhumoral immune responseIBDimmunomodulatory therapySARS-CoV-2

Identifiers

PMID36844197
PMCPMC9947701

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.