Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica
Objectives Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are overlapping autoinflammatory diseases affecting people over 50 years. The diseases are treated with immunosuppressive drugs such as prednisolone, methotrexate, leflunomide and tocilizumab. In this study, we assessed the immun...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-09-01
|
| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/8/2/e002479.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850130585366822912 |
|---|---|
| author | Elisabeth Brouwer Kornelis S M van der Geest Maria Sandovici Yannick van Sleen Janneke H Terpstra Marieke van der Heiden Debbie van Baarle Rosanne D Reitsema Idil Esen Elisabeth Raveling-Eelsing Thomas Lieber Annemarie M Buisman |
| author_facet | Elisabeth Brouwer Kornelis S M van der Geest Maria Sandovici Yannick van Sleen Janneke H Terpstra Marieke van der Heiden Debbie van Baarle Rosanne D Reitsema Idil Esen Elisabeth Raveling-Eelsing Thomas Lieber Annemarie M Buisman |
| author_sort | Elisabeth Brouwer |
| collection | DOAJ |
| description | Objectives Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are overlapping autoinflammatory diseases affecting people over 50 years. The diseases are treated with immunosuppressive drugs such as prednisolone, methotrexate, leflunomide and tocilizumab. In this study, we assessed the immunogenicity and safety of SARS-CoV-2 vaccinations in these diseases (based on humoral and cellular immunity).Methods Patients (n=45 GCA, n=33 PMR) visited the outpatient clinic twice: pre-vaccination and 4 weeks after the second dose (BNT162b2 or ChAdOx1 vaccine). Patients with previous SARS-CoV-2 infection were excluded. In both pre-vaccination and post-vaccination samples, anti-Spike antibody concentrations were assessed and compared with age-, sex- and vaccine-matched control groups (n=98). In addition, the frequency of SARS-CoV-2 Spike-specific T-cells was assessed by IFN-γ ELIspot assay, and side effects and disease activity were recorded.Results GCA/PMR patients did not have reduced antibody concentrations compared with controls. However, linear regression analysis revealed a significant association of methotrexate and >10 mg/day prednisolone use with lower antibody concentrations in GCA/PMR patients. Evidence of cellular immunity, as assessed by ELIspot assay, was found in 67% of GCA/PMR patients. Patients using >10 mg/day prednisolone had reduced cellular immunity. Importantly, vaccination did not lead to significant side effects or changes in disease activity.Conclusions SARS-CoV-2 vaccination was safe for GCA/PMR patients and immunogenicity was comparable to other older individuals. However, patients using methotrexate and particularly >10 mg/day prednisolone did show lower vaccine responses, which corroborates findings in other autoinflammatory patient populations. These patients may therefore be at higher risk of (potentially even severe) breakthrough SARS-CoV-2 infection. |
| format | Article |
| id | doaj-art-76c7e8068fd342b7b2e4a6545ce65972 |
| institution | OA Journals |
| issn | 2056-5933 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-76c7e8068fd342b7b2e4a6545ce659722025-08-20T02:32:41ZengBMJ Publishing GroupRMD Open2056-59332022-09-018210.1136/rmdopen-2022-002479Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumaticaElisabeth Brouwer0Kornelis S M van der Geest1Maria Sandovici2Yannick van Sleen3Janneke H Terpstra4Marieke van der Heiden5Debbie van Baarle6Rosanne D Reitsema7Idil Esen8Elisabeth Raveling-Eelsing9Thomas Lieber10Annemarie M Buisman11Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The Netherlands1 Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The NetherlandsUniversity of Groningen, University Medical Center Groningen, Groningen, NetherlandsDepartment of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Medical Microbiology and Infection Prevention, University Medical Center Groningen, Groningen, The NetherlandsVirology and Immunology Research Group, Department of Medical Microbiology and Infection Prevention, University Medical Centre, Groningen, The NetherlandsDepartment of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Rheumatology and Clinical Immunology, University Medical Center Groningen, Groningen, The NetherlandsNetherlands Pharmacovigilance Centre Lareb, `s-Hertogenbosch, The NetherlandsCentre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The NetherlandsObjectives Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are overlapping autoinflammatory diseases affecting people over 50 years. The diseases are treated with immunosuppressive drugs such as prednisolone, methotrexate, leflunomide and tocilizumab. In this study, we assessed the immunogenicity and safety of SARS-CoV-2 vaccinations in these diseases (based on humoral and cellular immunity).Methods Patients (n=45 GCA, n=33 PMR) visited the outpatient clinic twice: pre-vaccination and 4 weeks after the second dose (BNT162b2 or ChAdOx1 vaccine). Patients with previous SARS-CoV-2 infection were excluded. In both pre-vaccination and post-vaccination samples, anti-Spike antibody concentrations were assessed and compared with age-, sex- and vaccine-matched control groups (n=98). In addition, the frequency of SARS-CoV-2 Spike-specific T-cells was assessed by IFN-γ ELIspot assay, and side effects and disease activity were recorded.Results GCA/PMR patients did not have reduced antibody concentrations compared with controls. However, linear regression analysis revealed a significant association of methotrexate and >10 mg/day prednisolone use with lower antibody concentrations in GCA/PMR patients. Evidence of cellular immunity, as assessed by ELIspot assay, was found in 67% of GCA/PMR patients. Patients using >10 mg/day prednisolone had reduced cellular immunity. Importantly, vaccination did not lead to significant side effects or changes in disease activity.Conclusions SARS-CoV-2 vaccination was safe for GCA/PMR patients and immunogenicity was comparable to other older individuals. However, patients using methotrexate and particularly >10 mg/day prednisolone did show lower vaccine responses, which corroborates findings in other autoinflammatory patient populations. These patients may therefore be at higher risk of (potentially even severe) breakthrough SARS-CoV-2 infection.https://rmdopen.bmj.com/content/8/2/e002479.full |
| spellingShingle | Elisabeth Brouwer Kornelis S M van der Geest Maria Sandovici Yannick van Sleen Janneke H Terpstra Marieke van der Heiden Debbie van Baarle Rosanne D Reitsema Idil Esen Elisabeth Raveling-Eelsing Thomas Lieber Annemarie M Buisman Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica RMD Open |
| title | Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| title_full | Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| title_fullStr | Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| title_full_unstemmed | Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| title_short | Humoral and cellular SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| title_sort | humoral and cellular sars cov 2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica |
| url | https://rmdopen.bmj.com/content/8/2/e002479.full |
| work_keys_str_mv | AT elisabethbrouwer humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT kornelissmvandergeest humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT mariasandovici humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT yannickvansleen humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT jannekehterpstra humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT mariekevanderheiden humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT debbievanbaarle humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT rosannedreitsema humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT idilesen humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT elisabethravelingeelsing humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT thomaslieber humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica AT annemariembuisman humoralandcellularsarscov2vaccineresponsesinpatientswithgiantcellarteritisandpolymyalgiarheumatica |