Evidence map›Paper›PMID 37243801›Full record

ArticleClinical rheumatology2023

Impact of rituximab on humoral response to SARS-CoV-2 vaccination in previously vaccinated patients with autoimmune diseases.

E Oliosi, A Flahault, C Charre, D Veyer, A Combier, E Lafont, A Karras, L Mouthon, J Avouac, B Terrier and 1 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
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

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
  5. 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

11 authors at 3 institutions in 1 country.

E OliosiDepartment of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Cochin, Université de Paris Cité, 75014, Paris, France. emma.oliosi@aphp.fr.
A FlahaultDepartment of Nephrology, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
C CharreDepartment of Virology, AP-HP, Hôpital Cochin, 75014, Paris, France.
D VeyerDepartment of Virology, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
A CombierDepartment of Rheumatology, AP-HP, Hôpital Cochin, 75014, Paris, France.
E LafontDepartment of Internal Medicine, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
A KarrasDepartment of Nephrology, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
L MouthonDepartment of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Cochin, Université de Paris Cité, 75014, Paris, France.
J AvouacDepartment of Rheumatology, AP-HP, Hôpital Cochin, 75014, Paris, France.
B TerrierDepartment of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Cochin, Université de Paris Cité, 75014, Paris, France.
J HadjadjDepartment of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Cochin, Université de Paris Cité, 75014, Paris, France.ORCID http://orcid.org/0000-0002-2520-3272
Assistance Publique – Hôpitaux de Paris · FRUniversité Paris Cité · FRHôpital Cochin · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

SARS-CoV-2 infection is more severe in patients undergoing rituximab (RTX) treatment. Humoral response to vaccination is severely impaired in patients already treated with RTX, but data on antibody persistence in patients initiating RTX are lacking. We evaluated the impact of RTX initiation on humoral response to SARS-CoV-2 vaccination in previously vaccinated patients with immune-mediated inflammatory diseases. We performed a retrospective, multicenter study evaluating the evolution of anti-spike antibodies and breakthrough infections after initiation of RTX in previously vaccinated patients with protective levels of anti-SARS-CoV-2 antibodies. Threshold for anti-S antibodies positivity and protection were 30 and 264 BAU/mL, respectively. We included 31 previously vaccinated patients initiating RTX (21 female, median age 57 years). At first RTX infusion, 12 (39%) patients had received 2 doses of vaccine, 15 (48%) had received 3 doses, and 4 (13%) had received 4 doses. The most frequent underlying diseases were ANCA-associated vasculitis (29%) and rheumatoid arthritis (23%). Median anti-S antibody titers at RTX initiation, 3 months, and 6 months were 1620 (589-2080), 1055 (467-2080), and 407 (186-659) BAU/mL, respectively. Overall, antibody titers waned by almost two-fold at 3 months and four-fold at 6 months. Median antibody titers were significantly higher in patients who received ≥3 doses compared to those who received only 2 doses. Three patients developed SARS-CoV-2 infection without any severe symptom. Anti-SARS-CoV-2 antibody titers in previously vaccinated patients decline after RTX initiation similarly to general population. Specific monitoring is useful to anticipate prophylactic strategies. Key Points • Anti-SARS-CoV-2 antibody titers in previously vaccinated patients decline after rituximab initiation similarly to the general population. • The number of dose of vaccine before rituximab initiation is associated with higher antibody titers at month 3. • Monitoring antibody levels is mandatory to initiate prophylactic strategies in this population.

Indexed as

Autoimmune DiseasesCOVID-19Antibodies, ViralCOVID-19 VaccinesFemaleHumansMiddle AgedRetrospective StudiesRituximabSARS-CoV-2VaccinationAntibodies, ViralCOVID-19 VaccinesRituximabBiological therapyRituximabSARS-CoV-2Vaccines

Identifiers

PMID37243801
PMCPMC10224652
OpenAlexW4378549371

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.