Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases.
antirheumatic agents
methotrexate
rituximab
tumour necrosis factor inhibitors
vaccination
Journal
Annals of the rheumatic diseases
ISSN: 1468-2060
Titre abrégé: Ann Rheum Dis
Pays: England
ID NLM: 0372355
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
27
07
2021
accepted:
25
08
2021
pubmed:
9
9
2021
medline:
1
10
2021
entrez:
8
9
2021
Statut:
ppublish
Résumé
Patients with rheumatic diseases are at increased risk of infectious complications; vaccinations are a critical component of their care. Disease-modifying antirheumatic drugs may reduce the immunogenicity of common vaccines. We will review here available data regarding the effect of these medications on influenza, pneumococcal, herpes zoster, SARS-CoV-2, hepatitis B, human papilloma virus and yellow fever vaccines. Rituximab has the most substantial impact on vaccine immunogenicity, which is most profound when vaccinations are given at shorter intervals after rituximab dosing. Methotrexate has less substantial effect but appears to adversely impact most vaccine immunogenicity. Abatacept likely decrease vaccine immunogenicity, although these studies are limited by the lack of adequate control groups. Janus kinase and tumour necrosis factor inhibitors decrease absolute antibody titres for many vaccines, but do not seem to significantly impact the proportions of patients achieving seroprotection. Other biologics (interleukin-6R (IL-6R), IL-12/IL-23 and IL-17 inhibitors) have little observed impact on vaccine immunogenicity. Data regarding the effect of these medications on the SARS-CoV-2 vaccine immunogenicity are just now emerging, and early glimpses appear similar to our experience with other vaccines. In this review, we summarise the most recent data regarding vaccine response and efficacy in this setting, particularly in light of current vaccination recommendations for immunocompromised patients.
Identifiants
pubmed: 34493491
pii: annrheumdis-2021-221244
doi: 10.1136/annrheumdis-2021-221244
pmc: PMC8494475
mid: NIHMS1738048
doi:
Substances chimiques
Antirheumatic Agents
0
COVID-19 Vaccines
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1255-1265Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR002370
Pays : United States
Organisme : NIAMS NIH HHS
ID : P30 AR072583
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: MAF has received consulting fees for Revolo. JTR serves on ACIP HZ Workgroup, lead of ACR COVID Vaccine Guidance Task Force, member of ACR COVID-19 Vaccine Clinical Guideline Task Force, and is a member of EULAR Vaccine Guidance Task Force. JTR receives research grants and/or consulting for unrelated work: Amgen, Abbvie, BMS, CORRONA, Genentech, GSK, Lilly, Janssen, Novartis, Pfizer, UCB. KLW receives support from BMS and Pfizer. KLW has received consulting fees from Pfizer, AbbVie, Union Chimique Belge (UCB), Eli Lilly & Company, Galapagos, GlaxoSmithKline (GSK), Roche, Gilead, BMS, Regeneron, Sanofi, AstraZeneca and Novartis.
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