Abstract
Rituximab (RTX), an important therapeutic option for patients with rheumatic diseases, has been shown to reduce immune responses to various vaccines. We asked whether following SARS-CoV-2 vaccination, response rates in RTX treated patients are reduced and whether specific patient characteristics influence the responses. We recruited patients on chronic RTX therapy undergoing anti-SARS-CoV2 vaccination and measured the post-vaccination anti-spike IgG antibody levels. The median time from pre-vaccination RTX infusion to vaccination and from vaccination to the post-vaccination RTX infusion was 20.5 weeks and 7.2 weeks respectively. Only 36.5% of patients developed measurable titers of IgG anti-SARS-CoV-2 spike antibody after vaccination. Hypogammaglobulinemia (IgG and/or IgM) but not timing of vaccination, B cell numbers, or concomitant immune suppressive medications, correlated with sero-negativity (p = 0.004). Our results underscore the fact that even after B cell reconstitution, RTX induced chronic hypogammaglobulinemia significantly impairs the ability of the immune system to respond to SARS-CoV-2 vaccination.
Keywords: Autoimmune diseases; B cells; COVID-19; Rituximab; Vaccination.
【저자키워드】 COVID-19, B cells, rituximab, vaccination., Autoimmune diseases, 【초록키워드】 IgG, IgM, Rheumatic diseases, immune response, vaccination, therapy, Vaccines, antibody, immune system, medications, anti-SARS-CoV-2, immune, B cell, Characteristics, anti-Spike IgG, Patient, SARS-CoV-2 vaccination, Hypogammaglobulinemia, therapeutic option, median time, pre-vaccination, responses, shown, significantly, recruited, reduced, correlated, reduce, respond, impair, asked, RTX, titers of IgG, treated patient, 【제목키워드】 immunogenicity, SARS-CoV-2 vaccination, parameter, Effect,