{"id":21765,"date":"2022-06-21T05:16:00","date_gmt":"2022-06-20T21:16:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21765"},"modified":"2022-06-21T05:41:00","modified_gmt":"2022-06-20T21:41:00","slug":"lancet-rheumatol%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97%e5%88%a9%e5%a6%a5%e6%98%94%e5%8d%95%e6%8a%97%e6%b2%bb%e7%96%97%e7%9a%84%e7%b1%bb%e9%a3%8e%e6%b9%bf%e5%85%b3%e8%8a%82","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21765","title":{"rendered":"[Lancet Rheumatol\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7\u5229\u59a5\u6614\u5355\u6297\u6cbb\u7597\u7684\u7c7b\u98ce\u6e7f\u5173\u8282\u708e\u60a3\u8005\u63a5\u79cd\u4e24\u9488\u548c\u4e09\u9488\u65b0\u51a0\u75c5\u6bd2\u75ab\u82d7\u7684\u4f53\u6db2\u514d\u75ab\u53ca\u7ec6\u80de\u514d\u75ab\u53cd\u5e94"},"content":{"rendered":"\n

ARTICLES| VOLUME 4, ISSUE 3<\/a>, E177-E187, MARCH 01, 2022<\/p>\n\n\n\n

Humoral and cellular immune responses to two and three doses of SARS-CoV-2 vaccines in rituximab-treated patients with rheumatoid arthritis: a prospective, cohort study<\/h1>\n\n\n\n

Ingrid Jyssum, Hassen Kared, Trung T Tran,\u00a0et al<\/h3>\n\n\n\n

Lancet Rheumatol 2022; 4: e177-e187<\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

In rituximab-treated patients with rheumatoid arthritis, humoral and cellular immune responses after two or three doses of SARS-CoV-2 vaccines are not well characterised. We aimed to address this knowledge gap.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

This prospective, cohort study (Nor-vaC) was done at two hospitals in Norway. For this sub-study, we enrolled patients with rheumatoid arthritis on rituximab treatment and healthy controls who received SARS-CoV-2 vaccines according to the Norwegian national vaccination programme. Patients with insufficient serological responses to two doses (antibody to the receptor-binding domain [RBD] of the SARS-CoV-2 spike protein concentration <100 arbitrary units [AU]\/mL) were allotted a third vaccine dose. Antibodies to the RBD of the SARS-CoV-2 spike protein were measured in serum 2\u20134 weeks after the second and third doses. Vaccine-elicited T-cell responses were assessed in vitro using blood samples taken before and 7\u201310 days after the second dose and 3 weeks after the third dose from a subset of patients by stimulating cryopreserved peripheral blood mononuclear cells with spike protein peptides. The main outcomes were the proportions of participants with serological responses (anti-RBD antibody concentrations of \u226570 AU\/mL) and T-cell responses to spike peptides following two and three doses of SARS-CoV-2 vaccines. The study is registered at ClinicalTrials.gov<\/a>, NCT04798625<\/a>, and is ongoing.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between Feb 9, 2021, and May 27, 2021, 90 patients were enrolled, 87 of whom donated serum and were included in our analyses (69 [79\u00b73%] women and 18 [20\u00b77%] men). 1114 healthy controls were included (854 [76\u00b77%] women and 260 [23\u00b73%] men). 49 patients were allotted a third vaccine dose. 19 (21\u00b78%) of 87 patients, compared with 1096 (98\u00b74%) of 1114 healthy controls, had a serological response after two doses (p<0\u00b70001). Time since last rituximab infusion (median 267 days [IQR 222\u2013324] in responders vs<\/em>107 days [80\u2013152] in non-responders) and vaccine type (mRNA-1273 vs<\/em> BNT162b2) were significantly associated with serological response (adjusting for age and sex). After two doses, 10 (53%) of 19 patients had CD4+<\/sup> T-cell responses and 14 (74%) had CD8+<\/sup> T-cell responses. A third vaccine dose induced serological responses in eight (16\u00b73%) of 49 patients, but induced CD4+<\/sup> and CD8+<\/sup> T-cell responses in all patients assessed (n=12), including responses to the SARS-CoV-2 delta variant (B.1.617.2). Adverse events were reported in 32 (48%) of 67 patients and in 191 (78%) of 244 healthy controls after two doses, with the frequency not increasing after the third dose. There were no serious adverse events or deaths.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

This study provides important insight into the divergent humoral and cellular responses to two and three doses of SARS-CoV-2 vaccines in rituximab-treated patients with rheumatoid arthritis. A third vaccine dose given 6\u20139 months after a rituximab infusion might not induce a serological response, but could be considered to boost the cellular immune response.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

The Coalition for Epidemic Preparedness Innovations, Research Council of Norway Covid, the KG Jebsen Foundation, Oslo University Hospital, the University of Oslo, the South-Eastern Norway Regional Health Authority, Dr Trygve Gythfeldt og frues forskningsfond, the Karin Fossum Foundation, and the Research Foundation at Diakonhjemmet Hospital.<\/p>\n","protected":false},"excerpt":{"rendered":"

ARTICLES| VOLUME 4, ISSUE 3, E177-E187,  […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21765"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21765"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21765\/revisions"}],"predecessor-version":[{"id":21766,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21765\/revisions\/21766"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21765"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21765"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21765"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}