Humoral immunogenicity after vaccination with the fourth dose of COVID-19 in patients with immunomediated inflammatory diseases

Abstract

Introduction

On the whole, vaccines against COVID-19 have shown a good level of efficacy and safety, but in the subgroup of patients with immune-mediated inflammatory diseases there are contradictory data about the existence of an inadequate immune response after the administration of the vaccine. The objective of this study is to know and determine the immunogenicity generated after the administration of the vaccine against COVID-19 in patients with these diseases being treated with targeted therapies.

Material and methods

An analytical, observational and cross-sectional study was carried out at the Miguel Servet University Hospital in Zaragoza (Spain) of the Ab levels generated after the administration of the 4th dose of the COVID-19 vaccine in patients diagnosed with with immune-mediated inflammatory diseases and being treated with targeted therapies.

Results

A total of 243 patients were included. Only 3.3% of patients showed an inadequate post-vaccine immune response. It was observed that patients with seropositive rheumatoid arthritis showed a higher risk of presenting decreased post-vaccine antibodies IgG levels compared to other diseases such as spondyloarthritis B27 + (OR 0.039) or psoriatic arthritis (OR 0.023). Patients treated with tumour necrosis factor inhibitors drugs had a lower risk of generating decreased post-vaccine antibodies IgG levels compared to other targeted therapies such as abatacept (OR 20.03) or JAK inhibitors (OR 4.12).

Conclusion

The type of immune-mediated inflammatory diseases and the targeted therapy used influence the immune response generated after vaccination against COVID-19. The diagnosis of seropositive rheumatoid arthritis and the use of certain targeted therapies such as abatacept or JAK inhibitors influence negatively in the formation of antibodies IgG after vaccination.