Reduced SARS-CoV-2 vaccine-specific antibody response associated with high clozapine doses in schizophrenia spectrum disorders

IF 3.5 Q2 IMMUNOLOGY
Itziar Montalvo , Juan Francisco Delgado , Albert Rodrigo-Parés , Teresa Sagués , Antoni Berenguer-Llergo , Raquel Rodríguez-González , Indira Bhambi , Patricia Pontón , Germà Julià , Virginia Soria , Diego Palao , Javier Labad
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Abstract

Background

Schizophrenia, affecting approximately 1 % of the population worldwide, is associated with increased mortality rates and a reduced life expectancy of 10–20 years. Approximately 30 % of cases are resistant to conventional antipsychotic treatments, necessitating the use of clozapine. Recent evidence suggests that clozapine exerts immunomodulatory effects, with individuals undergoing chronic clozapine treatment exhibiting immune profiles resembling primary immunodeficiencies.

Objective

To evaluate the immune response to vaccination with the spike protein of SARS-CoV-2 in schizophrenia patients treated with clozapine, compared to those receiving other antipsychotics.

Methods

The study included 98 patients diagnosed with schizophrenia or schizoaffective disorder, of whom 69 were treated with clozapine. Demographic, clinical, and laboratory data were collected for all participants. Anti-spike protein antibodies were measured using the Elecsys® Anti-SARS-CoV-2 S assay.

Results

No significant differences were observed in demographic, clinical, or laboratory parameters between the groups. Univariate analysis revealed that spike antibody levels were positively associated with smoking habits and more than two exposures to the virus, while they were negatively associated with the time elapsed since vaccination and clozapine dosage.
In multivariate analysis, patients receiving clozapine doses >350 mg/day exhibited a significant reduction in anti-spike antibody levels compared to those not treated with clozapine (fold change = 0.49 [0.24–0.97], p = 0.041) and those receiving <200 mg/day of clozapine (fold change = 0.39 [0.17–0.88], p = 0.024).

Conclusion

High doses of clozapine (>350 mg/day) in patients with schizophrenia and schizoaffective disorders are associated with a diminished immune response to SARS-CoV-2 spike protein vaccination.
精神分裂症谱系障碍患者高剂量氯氮平与SARS-CoV-2疫苗特异性抗体反应降低相关
精神分裂症影响全球约1%的人口,与死亡率增加和预期寿命减少10-20年有关。大约30%的病例对常规抗精神病药物有耐药性,需要使用氯氮平。最近的证据表明氯氮平具有免疫调节作用,接受慢性氯氮平治疗的个体表现出类似原发性免疫缺陷的免疫特征。目的评价氯氮平与其他抗精神病药物治疗的精神分裂症患者接种SARS-CoV-2刺突蛋白的免疫应答。方法本研究纳入98例精神分裂症或分裂情感性障碍患者,其中69例给予氯氮平治疗。收集所有参与者的人口学、临床和实验室数据。使用Elecsys®anti - sars - cov - 2s检测抗刺突蛋白抗体。结果两组在人口学、临床和实验室参数方面均无显著差异。单变量分析显示,尖峰抗体水平与吸烟习惯和两次以上病毒暴露呈正相关,而与接种疫苗后的时间和氯氮平剂量呈负相关。在多因素分析中,与未接受氯氮平治疗的患者相比,接受350 mg/天氯氮平治疗的患者抗尖峰抗体水平显著降低(倍差变化= 0.49 [0.24-0.97],p = 0.041),接受200 mg/天氯氮平治疗的患者(倍差变化= 0.39 [0.17-0.88],p = 0.024)。结论高剂量氯氮平(350 mg/d)与SARS-CoV-2刺突蛋白免疫应答降低有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain, behavior, & immunity - health
Brain, behavior, & immunity - health Biological Psychiatry, Behavioral Neuroscience
CiteScore
8.50
自引率
0.00%
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0
审稿时长
97 days
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