EFFICACY OF SARS-COV-2 VACCINE IN PATIENTS WITH RHEUMATIC DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Akhil Sood et al.
The authors of this abstract conducted a systematic review and meta-analysis on the humoral immune response of SARS-CoV-2 vaccination in patients with rheumatic disease (RD). The meta-analysis included eight studies (3 observational studies, 5 case-control studies) comprising 1482 RD patients with different rheumatic diseases.
The pooled response rate following vaccination against SARS-CoV-2 was 0.88 (95% CI 0.75-0.94). Compared to non-RD patients, RD patients had significantly decreased response to SARS-CoV-2 vaccination (RR 0.88, 95% 0.84-0.93). Patients on rituximab (37%), mycophenolate (70.8%), prednisone (86.6%), and methotrexate (91.9%) showed lower vaccine response. On the other hand, patients on TNF (100%), JAK (96.3%), and IL-17 inhibitors (92.9%) showed normal vaccine responses.
In this systematic review and meta-analysis, the majority of RD patients developed an immune response following a second dose of SARS-CoV-2 vaccine. However, the vaccine response rate was significantly lower in RD patients compared to controls and in patients on rituximab, prednisone and csDMARDs such as methotrexate and mycophenolate mofetil. bDMARDs and JAK inhibitors seem not to affect the immune response.
The Swiss Society of Rheumatology recommends to measure the immune response with a SARS-CoV-2 S antibody assay in all patients with RD under the above-mentioned drugs. If the response is insufficient a third «booster» vaccination is recommended.