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Current Rheumatology Reports

Erschienen in:

01.11.2021 | COVID-19 | Systemic Lupus Erythematosus (G Tsokos, Section Editor) Zur Zeit gratis

The Use of COVID-19 Vaccines in Patients with SLE

verfasst von: Wei Tang, Yevgeniya Gartshteyn, Edd Ricker, Sean Inzerillo, Shane Murray, Leila Khalili, Anca Askanase

Erschienen in: Current Rheumatology Reports | Ausgabe 11/2021

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Abstract

Purpose of Review

Three COVID-19 vaccines obtained emergency authorization from the Food and Drug Administration (FDA) and are widely used in the USA. Unfortunately, there is a paucity of evidence on the safety and efficacy of these vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD), as these patients were excluded from all phases of vaccine development. Here we reviewed current data on COVID-19 vaccination in patients with AIIRD, with emphasis on systemic lupus erythematosus (SLE), and provided a comprehensive update on the benefits and risks of vaccination.

Recent Findings

Patients with SLE have worse immune responses following SARS-CoV-2 vaccination than healthy controls. The efficacy of the COVID-19 vaccines seems to be further reduced by immunosuppressive medications, such as glucocorticoids (GC), methotrexate (MTX), mycophenolate/mycophenolic acid (MMF), and rituximab (RTX). However, these data do not substantiate that AIIRD patients are at greater risk of disease flares or have a higher incidence of side effects following vaccination. There is no significant safety concern for the use of COVID-19 vaccines in patients with AIIRD.

Summary

The benefits of vaccination far outweigh the risks in patients with AIIRD, including SLE. More data are needed to determine the necessity of a booster vaccine dose and appropriate adjustment of immunosuppressants around the administration of vaccine.

PM Heaton 2020 The Covid-19 Vaccine-Development Multiverse N Engl J Med 383 20 1986 1988 https://doi.org/10.1056/NEJMe2025111CrossRefPubMed

LR Baden HM Sahly El B Essink K Kotloff S Frey R Novak 2021 Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine N Engl J Med 384 5 403 416 https://doi.org/10.1056/NEJMoa2035389CrossRefPubMed

FP Polack SJ Thomas N Kitchin J Absalon A Gurtman S Lockhart 2020 Safety and efficacy of the BNT162b2 mRNA Covid-19 Vaccine N Engl J Med 383 27 2603 2615 https://doi.org/10.1056/NEJMoa2034577CrossRefPubMed

J Sadoff G Gray A Vandebosch V Cardenas G Shukarev B Grinsztejn 2021 Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19 N Engl J Med. 384 23 2187 201 https://doi.org/10.1056/NEJMoa2101544CrossRefPubMed

FDA Approves First COVID-19 Vaccine. https://www.fda.gov/news-events/press-announcements/fda-approves-first-covid-19-vaccine; 08/23/2021.

M Voysey SAC Clemens SA Madhi LY Weckx PM Folegatti PK Aley 2021 Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK Lancet 397 10269 99 111 https://doi.org/10.1016/S0140-6736(20)32661-1CrossRefPubMedPubMedCentral

R Fernandez-Ruiz JL Paredes TB Niewold 2021 COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease Transl Res 232 13 36 https://doi.org/10.1016/j.trsl.2020.12.007CrossRefPubMed

A Strangfeld M Schafer MA Gianfrancesco S Lawson-Tovey JW Liew L Ljung 2021 Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry Ann Rheum Dis 80 7 930 942 https://doi.org/10.1136/annrheumdis-2020-219498CrossRefPubMed

Tang W, Askanase AD, Khalili L, Merrill JT. SARS-CoV-2 vaccines in patients with SLE. Lupus Sci Med. 2021;8(1). doi: https://doi.org/10.1136/lupus-2021-000479.

10.

L Boekel F Hooijberg ZLE Kempen van EH Vogelzang SW Tas J Killestein 2021 Perspective of patients with autoimmune diseases on COVID-19 vaccination Lancet Rheumatol. 3 4 e241 e243 https://doi.org/10.1016/S2665-9913(21)00037-0CrossRefPubMedPubMedCentral

11.

JR Curtis SR Johnson DD Anthony RJ Arasaratnam LR Baden AR Bass 2021 American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3 Arthritis Rheumatol https://doi.org/10.1002/art.41928CrossRefPubMedPubMedCentral

12.

COVID-19 Booster Vaccine in Autoimmune Disease Non-Responders. https://ClinicalTrials.gov/show/NCT05000216.

13.

M Puges P Biscay T Barnetche ME Truchetet C Richez J Seneschal 2016 Immunogenicity and impact on disease activity of influenza and pneumococcal vaccines in systemic lupus erythematosus: a systematic literature review and meta-analysis Rheumatology (Oxford) 55 9 1664 1672 https://doi.org/10.1093/rheumatology/kew211CrossRef

14.

Izmirly PM, Kim MY, Samanovic M, Fernandez-Ruiz R, Ohana S, Deonaraine KK, et al. Evaluation of immune response and disease status in SLE patients following SARS-CoV-2 Vaccination. Arthritis Rheumatol. 2021. doi: https://doi.org/10.1002/art.41937.

15.

Boekel L, Steenhuis M, Hooijberg F, Besten YR, van Kempen ZLE, Kummer LY, et al. Antibody development after COVID-19 vaccination in patients with autoimmune diseases in the Netherlands: a substudy of data from two prospective cohort studies. Lancet Rheumatol. 2021. doi: https://doi.org/10.1016/S2665-9913(21)00222-8.

16.

Ammitzboll C, Bartels LE, Bogh Andersen J, Risbol Vils S, Elbaek Mistegard C, Dahl Johannsen A, et al. Impaired antibody response to the BNT162b2 messenger RNA coronavirus disease 2019 vaccine in patients with systemic lupus erythematosus and rheumatoid arthritis. ACR Open Rheumatol. 2021. doi: https://doi.org/10.1002/acr2.11299

17.

Ghione P, Gu JJ, Attwood K, Torka P, Goel S, Sundaram S, et al. Impaired humoral responses to COVID-19 vaccination in patients with lymphoma receiving B-cell directed therapies. Blood. 2021. doi: https://doi.org/10.1182/blood.2021012443

18.

Simon D, Tascilar K, Fagni F, Kronke G, Kleyer A, Meder C, et al. SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220461

19.

Furer V, Eviatar T, Zisman D, Peleg H, Paran D, Levartovsky D, et al. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220647

20.

C Rondaan V Furer MW Heijstek N Agmon-Levin M Bijl FC Breedveld 2019 Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations RMD Open 5 2 e001035 https://doi.org/10.1136/rmdopen-2019-001035CrossRefPubMedPubMedCentral

21.

P Deepak W Kim MA Paley M Yang AB Carvidi EG Demissie 2021 Effect of Immunosuppression on the immunogenicity of mRNA Vaccines to SARS-CoV-2: a prospective cohort study Ann Intern Med https://doi.org/10.7326/M21-1757CrossRefPubMedPubMedCentral

22.

L Fischer PF Gerstel A Poncet CA Siegrist E Laffitte C Gabay 2015 Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases–a longitudinal study Arthritis Res Ther 17 151 https://doi.org/10.1186/s13075-015-0663-9CrossRefPubMedPubMedCentral

23.

EF Borba CG Saad SG Pasoto AL Calich NE Aikawa AC Ribeiro 2012 Influenza A/H1N1 vaccination of patients with SLE: can antimalarial drugs restore diminished response under immunosuppressive therapy? Rheumatology (Oxford) 51 6 1061 1069 https://doi.org/10.1093/rheumatology/ker427CrossRef

24.

Ruddy JA, Connolly CM, Boyarsky BJ, Werbel WA, Christopher-Stine L, Garonzik-Wang J, et al. High antibody response to two-dose SARS-CoV-2 messenger RNA vaccination in patients with rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220656

25.

C Hua T Barnetche B Combe J Morel 2014 Effect of methotrexate, anti-tumor necrosis factor alpha, and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: a systematic review and meta-analysis Arthritis Care Res (Hoboken). 66 7 1016 1026 https://doi.org/10.1002/acr.22246CrossRefPubMed

26.

JK Park MA Lee EY Lee YW Song Y Choi KL Winthrop 2017 Effect of methotrexate discontinuation on efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial Ann Rheum Dis 76 9 1559 1565 https://doi.org/10.1136/annrheumdis-2017-211128CrossRefPubMed

27.

JK Park YJ Lee K Shin YJ Ha EY Lee YW Song 2018 Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial Ann Rheum Dis 77 6 898 904 https://doi.org/10.1136/annrheumdis-2018-213222CrossRefPubMed

28.

Haberman RH, Herati R, Simon D, Samanovic M, Blank RB, Tuen M, et al. Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220597

29.

V Oberhardt H Luxenburger J Kemming I Schulien K Ciminski S Giese 2021 Rapid and stable mobilization of CD8(+) T cells by SARS-CoV-2 mRNA vaccine Nature 597 7875 268 273 https://doi.org/10.1038/s41586-021-03841-4CrossRefPubMedPubMedCentral

30.

K McMahan J Yu NB Mercado C Loos LH Tostanoski A Chandrashekar 2021 Correlates of protection against SARS-CoV-2 in rhesus macaques Nature 590 7847 630 634 https://doi.org/10.1038/s41586-020-03041-6CrossRefPubMed

31.

A Al-Janabi Z Littlewood CEM Griffiths HJA Hunter H Chinoy C Moriarty 2021 Antibody responses to single-dose SARS-CoV-2 vaccination in patients receiving immunomodulators for immune-mediated inflammatory disease Br J Dermatol https://doi.org/10.1111/bjd.20479CrossRefPubMedPubMedCentral

32.

CC Mok LY Ho LS Fong CH To 2013 Immunogenicity and safety of a quadrivalent human papillomavirus vaccine in patients with systemic lupus erythematosus: a case-control study Ann Rheum Dis 72 5 659 664 https://doi.org/10.1136/annrheumdis-2012-201393CrossRefPubMed

33.

Y Peled E Ram J Lavee L Sternik A Segev A Wieder-Finesod 2021 BNT162b2 vaccination in heart transplant recipients: clinical experience and antibody response J Heart Lung Transplant 40 8 759 762 https://doi.org/10.1016/j.healun.2021.04.003CrossRefPubMedPubMedCentral

34.

A Grupper L Rabinowich D Schwartz IF Schwartz M Ben-Yehoyada M Shashar 2021 Reduced humoral response to mRNA SARS-CoV-2 BNT162b2 vaccine in kidney transplant recipients without prior exposure to the virus Am J Transplant 21 8 2719 2726 https://doi.org/10.1111/ajt.16615CrossRefPubMed

35.

BJ Boyarsky JA Ruddy CM Connolly MT Ou WA Werbel JM Garonzik-Wang 2021 Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases Ann Rheum Dis 80 8 1098 1099 https://doi.org/10.1136/annrheumdis-2021-220289CrossRef

36.

L Boekel LY Kummer KPJ Dam van F Hooijberg Z Kempen van EH Vogelzang 2021 Adverse events after first COVID-19 vaccination in patients with autoimmune diseases Lancet Rheumatol. 3 8 e542 e545 https://doi.org/10.1016/S2665-9913(21)00181-8CrossRefPubMedPubMedCentral

37.

Spiera R, Jinich S, Jannat-Khah D. Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220604

38.

39.

J Hadjadj N Yatim L Barnabei A Corneau J Boussier N Smith 2020 Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients Science 369 6504 718 724 https://doi.org/10.1126/science.abc6027CrossRefPubMedPubMedCentral

40.

M Postal JF Vivaldo R Fernandez-Ruiz JL Paredes S Appenzeller TB Niewold 2020 Type I interferon in the pathogenesis of systemic lupus erythematosus Curr Opin Immunol 67 87 94 https://doi.org/10.1016/j.coi.2020.10.014CrossRefPubMedPubMedCentral

41.

JR Teijaro DL Farber 2021 COVID-19 vaccines: modes of immune activation and future challenges Nat Rev Immunol 21 4 195 197 https://doi.org/10.1038/s41577-021-00526-xCrossRefPubMed

42.

E Wiesik-Szewczyk M Romanowska P Mielnik H Chwalinska-Sadowska LB Brydak M Olesinska 2010 Anti-influenza vaccination in systemic lupus erythematosus patients: an analysis of specific humoral response and vaccination safety Clin Rheumatol 29 6 605 613 https://doi.org/10.1007/s10067-010-1373-yCrossRefPubMed

43.

M Abu-Shakra J Press S Sukenik D Buskila 2002 Influenza virus vaccination of patients with SLE: effects on generation of autoantibodies Clin Rheumatol 21 5 369 372 https://doi.org/10.1007/s100670200099CrossRefPubMed

44.

R Felten M Dubois MF Ugarte-Gil A Chaudier L Kawka H Bergier 2021 Vaccination against COVID-19: expectations and concerns of patients with autoimmune and rheumatic diseases Lancet Rheumatol. 3 4 e243 e245 https://doi.org/10.1016/S2665-9913(21)00039-4CrossRefPubMedPubMedCentral

45.

CM Connolly JA Ruddy BJ Boyarsky RK Avery WA Werbel DL Segev 2021 Safety of the first dose of mRNA SARS-CoV-2vaccines inpatients with rheumatic and musculoskeletal diseases Ann Rheum Dis https://doi.org/10.1136/annrheumdis-2021-220231CrossRefPubMed

46.

Geisen UM, Berner DK, Tran F, Sumbul M, Vullriede L, Ciripoi M, et al. Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort. Ann Rheum Dis. 2021. doi: https://doi.org/10.1136/annrheumdis-2021-220272

47.

R Felten L Kawka M Dubois MF Ugarte-Gil Y Fuentes-Silva M Piga 2021 Tolerance of COVID-19 vaccination in patients with systemic lupus erythematosus: the international VACOLUP study Lancet Rheumatol. https://doi.org/10.1016/S2665-9913(21)00221-6CrossRefPubMedPubMedCentral

48.

Watad A, De Marco G, Mahajna H, Druyan A, Eltity M, Hijazi N, et al. Immune-mediated disease flares or new-onset disease in 27 subjects following mRNA/DNA SARS-CoV-2 Vaccination. Vaccines (Basel). 2021;9(5). doi: https://doi.org/10.3390/vaccines9050435.

49.

A Greinacher T Thiele TE Warkentin K Weisser PA Kyrle S Eichinger 2021 Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination N Engl J Med 384 22 2092 2101 https://doi.org/10.1056/NEJMoa2104840CrossRefPubMed

50.

CDC: COVID Data Tracker https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-total-admin-rate-total Accessed 09/01/2021

51.

CDC: SARS-CoV-2 Variant Classifications and Definitions. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html Accessed 09/01/2021.

Titel: The Use of COVID-19 Vaccines in Patients with SLE
verfasst von: Wei Tang
Yevgeniya Gartshteyn
Edd Ricker
Sean Inzerillo
Shane Murray
Leila Khalili
Anca Askanase
Publikationsdatum: 01.11.2021
Verlag: Springer US
Schlagwort: COVID-19
Erschienen in: Current Rheumatology Reports / Ausgabe 11/2021
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-021-01046-2

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The Use of COVID-19 Vaccines in Patients with SLE