Impact of Immunomodulatory Therapy on COVID-19 Vaccine Response in Patients with Autoimmune Inflammatory Rheumatic Diseases

被引:4
|
作者
Yap, Ruth Xian Lynn [1 ]
Lai, Yi Wye [1 ]
Wei, Chang [2 ]
Ng, Joel Jia Wei [3 ]
Xu, Dan [2 ]
Feng, Shuo [4 ]
Mu, Rong [2 ]
Thong, Bernard Yu-Hor [1 ]
Xu, Chuanhui [1 ]
机构
[1] Tan Tock Seng Hosp, Dept Rheumatol Allergy & Immunol, Singapore 308433, Singapore
[2] Peking Univ Third Hosp, Dept Rheumatol & Immunol, Beijing 100191, Peoples R China
[3] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore 119077, Singapore
[4] Univ Oxford, Dept Paediat, Oxford Vaccine Grp, Oxford OX1 2JD, England
关键词
vaccination; COVID-19; autoimmune inflammatory rheumatic disease; immunogenicity; METHOTREXATE;
D O I
10.3390/vaccines12030274
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Coronavirus disease 2019 (COVID-19) vaccination is essential for patients with autoimmune inflammatory rheumatic diseases (AIIRD) to reduce the risk of morbidity and mortality associated with serious COVID-19 infection. With endemicity, waning of vaccine- and infection-acquired immunity, and development of SARS-CoV-2 variants, the need for additional doses of vaccines against serious illness in high-risk immunocompromised persons remains imperative. This review examines how immunomodulatory therapies affect vaccine-induced immune response in patients with AIIRD. Glucocorticoids, methotrexate, azathioprine, calcineurin inhibitors, mycophenolate mofetil, tumor necrosis factor inhibitors, and abatacept have been shown to variably attenuate both humoral and cellular immune responses to vaccination. Janus kinase inhibitors reduce humoral immune response. In contrast, sulfasalazine, leflunomide, belimumab, interleukin (IL)-17, IL-12/23, IL-6, and IL-1 inhibitors appear favorable, with mild or no impact on vaccine response. Although rituximab is known to profoundly diminish humoral immune response, cellular immunity is relatively preserved. Administering a third and subsequent vaccine dose or temporally coordinating the dosing of immunomodulatory drugs may improve vaccine effectiveness. Further research is needed to personalise vaccination strategies for AIIRD patients, considering their specific immunomodulatory treatments.
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页数:12
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