ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0701

Reduced Humoral but Maintained Cellular Immune Response to a 3rd COVID-19 Vaccination in Patients with Immune-Mediated Inflammatory Diseases as Compared to Healthy Controls over a 3-months Observational Period

Daniel Mrak1, Felix Kartnig1, Daniela Sieghart1, Elisabeth Simader1, Helga Radner1, Peter mandl2, Lisa Göschl1, Philipp Hofer3, Thomas Hummel1, Thomas Deimel4, Irina Gessl4, Renate Kain5, Stefan Winkler6, Josef Smolen4, Thomas Perkmann7, Helmuth Haslacher7, Daniel Aletaha8, Leonhard Heinz1 and Michael Bonelli1, 1Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria, 2Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Wien, Austria, 3Department of Pathology, Medical University of Vienna, Vienna, Austria, 4Medical University of Vienna, Vienna, Austria, 5Department of Pathology, Medical University of Vienna, Vienna, 6Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria, 7Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria, 8Medical University Vienna, Wien, Austria

Meeting: ACR Convergence 2022

Keywords:

Session Information

Date: Sunday, November 13, 2022

Title: Epidemiology and Public Health Poster I

Session Type: Poster Session B

Session Time: 9:00AM-10:30AM

Background/Purpose: A third COVID-19 vaccination is currently recommended for patients under immunosuppression. However, a fast decline of antibodies against the SARS-CoV-2 receptor-binding domain (RBD) of the spike protein has been reported. Currently it remains unclear whether immunosuppressive therapy affects stability of a humoral and cellular immune response.

Methods: 51 patients with immune-mediated inflammatory diseases (IMID) under immunosuppression and 45 healthy controls (HCs) received a 3rd dose of an mRNA-based vaccination and were monitored over a 12-weeks period. Humoral immune response was assessed 4 and 12 weeks after 3rd dose. Antibodies were quantified using the Elecsys Anti-SARS-CoV-2 S immunoassay against the receptor-binding domain (RBD) of the spike protein. SARS-CoV-2-specific T cell responses were analyzed 1 and 12 weeks after 3rd dose and were quantified by IFN-γ ELISpot assays. Adverse events, including SARS-CoV-2 infections, were monitored over a 12-week period.

Results: At week 12 reduced anti-RBD antibody levels were observed in IMID patients as compared HCs (median antibody level 5400 BAU/ml [2074, 10400] versus 9500 BAU/ml [6610, 16300], p=0.003). Relative reduction in antibody levels was significantly higher in IMID patients as compared to HCs at week 12 (p=0.003). Lowest levels of anti-RBD antibody levels were detected in IMID patients who received a combination therapy with conventional synthetic and biological diseases modifying anti-rheumatic drugs. Number of SARS-CoV-2 specific T cells remained stable over 12 weeks in IMID patients and HCs. No serious adverse events were reported. Two IMID patients and two HCs were tested positive for SARS-CoV-2 between week 4 and 12.

Conclusion: A fast decline in anti-RBD antibodies was observed in IMID patients under immunosuppression. A 4th vaccination should therefore be considered in this vulnerable group of patients.

Supporting image 1

Figure 1: Humoral immune response 4 and 12 weeks after 3rd vaccine dose in healthy controls (HCs) and patients. Antibodies to the receptor-binding domain (RBD) of the viral spike (S) protein were determined using an anti-SARS-CoV_2 immunoassay.

Supporting image 2

Figure 2: Relative change of anti-SARS-CoV_2 RBD antibodies between week 4 and week 12 after 3rd vaccine dose in healthy controls (HCs) as compared to patients

Disclosures: D. Mrak, Pfizer; F. Kartnig, Boehringer-Ingelheim, Eli Lilly; D. Sieghart, None; E. Simader, Boehringer-Ingelheim; H. Radner, None; P. mandl, AbbVie, Bristol-Myers Squibb(BMS), Celgene, Janssen, Eli Lilly, Novartis, Merck/MSD, Roche, UCB; L. Göschl, None; P. Hofer, None; T. Hummel, None; T. Deimel, None; I. Gessl, Eli Lilly, Boehringer-Ingelheim, Gilead; R. Kain, None; S. Winkler, None; J. Smolen, AbbVie, AstraZeneca, Eli Lilly, Novartis, Amgen, Bristol Myers Squibb, Galapagos-Gilead, Janssen, Merck-Sharp-Dohme, Novartis-Sandoz, Pfizer, Roche-Chugai, Samsung, UCB; T. Perkmann, None; H. Haslacher, Glock Health, BlueSky Immunotherapies, Neutrolis; D. Aletaha, Novartis, SoBi, Sanofi, Amgen, Lilly, Merck, Pfizer, Roche, Sandoz, Janssen, AbbVie; L. Heinz, None; M. Bonelli, Eli Lilly.

To cite this abstract in AMA style:

Mrak D, Kartnig F, Sieghart D, Simader E, Radner H, mandl P, Göschl L, Hofer P, Hummel T, Deimel T, Gessl I, Kain R, Winkler S, Smolen J, Perkmann T, Haslacher H, Aletaha D, Heinz L, Bonelli M. Reduced Humoral but Maintained Cellular Immune Response to a 3rd COVID-19 Vaccination in Patients with Immune-Mediated Inflammatory Diseases as Compared to Healthy Controls over a 3-months Observational Period [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/reduced-humoral-but-maintained-cellular-immune-response-to-a-3rd-covid-19-vaccination-in-patients-with-immune-mediated-inflammatory-diseases-as-compared-to-healthy-controls-over-a-3-months-observation/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/reduced-humoral-but-maintained-cellular-immune-response-to-a-3rd-covid-19-vaccination-in-patients-with-immune-mediated-inflammatory-diseases-as-compared-to-healthy-controls-over-a-3-months-observation/