Habermann, Elisa ORCID: 0000-0003-1504-4746, Gieselmann, Lutz ORCID: 0000-0003-3699-3318, Tober-Lau, Pinkus ORCID: 0000-0002-9148-3663, Klotsche, Jens, Albach, Fredrik Nils, Ten Hagen, Alexander, Zernicke, Jan, Ahmadov, Elvin, de Silva, Amanthi Nadira Arumahandi, Frommert, Leonie Maria ORCID: 0000-0003-0110-9190, Kurth, Florian ORCID: 0000-0002-3807-473X, Sander, Leif Erik, Burmester, Gerd R., Klein, Florian ORCID: 0000-0003-1376-1792 and Biesen, Robert ORCID: 0000-0002-0434-7832 (2022). Pausing methotrexate prevents impairment of Omicron BA.1 and BA.2 neutralisation after COVID-19 booster vaccination. RMD Open, 8 (2). LONDON: BMJ PUBLISHING GROUP. ISSN 2056-5933

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Abstract

Objective The level of neutralising capacity against Omicron BA.1 and BA.2 after third COVID-19 vaccination in patients on paused or continuous methotrexate (MTX) therapy is unclear. Methods In this observational cohort study, neutralising serum activity against SARS-CoV-2 wild-type (Wu01) and variant of concern Omicron BA.1 and BA.2 were assessed by pseudovirus neutralisation assay before, 4 and 12 weeks after mRNA booster immunisation in 50 rheumatic patients on MTX, 26 of whom paused the medication. 44 non-immunosuppressed persons (NIP) served as control group. Results While the neutralising serum activity against SARS-CoV-2 Wu01 and Omicron variants increased 67-73 fold in the NIP after booster vaccination, the serum activity in patients receiving MTX increased only 20-23 fold. Patients who continued MTX treatment during vaccination had significantly lower neutralisation against all variants at weeks 4 and 12 compared with patients who paused MTX and the control group, except for BA.2 at week 12. Patients who paused MTX reached comparably high neutralising capacities as NIP, except for Wu01 at week 12. The duration of the MTX pause after-not before-was associated with a significantly higher neutralisation capacity against all three variants, with an optimal duration at 10 days after vaccination. Conclusion Patients pausing MTX after COVID-19 booster showed a similar vaccine response to NIP. Patients who continued MTX demonstrated an impaired response indicating a potentially beneficial second booster vaccination. Our data also suggest that a 1 week MTX break is sufficient if the last administration of MTX occurs 1-3 days before vaccination.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Habermann, ElisaUNSPECIFIEDorcid.org/0000-0003-1504-4746UNSPECIFIED
Gieselmann, LutzUNSPECIFIEDorcid.org/0000-0003-3699-3318UNSPECIFIED
Tober-Lau, PinkusUNSPECIFIEDorcid.org/0000-0002-9148-3663UNSPECIFIED
Klotsche, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Albach, Fredrik NilsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ten Hagen, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zernicke, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ahmadov, ElvinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Silva, Amanthi Nadira ArumahandiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frommert, Leonie MariaUNSPECIFIEDorcid.org/0000-0003-0110-9190UNSPECIFIED
Kurth, FlorianUNSPECIFIEDorcid.org/0000-0002-3807-473XUNSPECIFIED
Sander, Leif ErikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burmester, Gerd R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klein, FlorianUNSPECIFIEDorcid.org/0000-0003-1376-1792UNSPECIFIED
Biesen, RobertUNSPECIFIEDorcid.org/0000-0002-0434-7832UNSPECIFIED
URN: urn:nbn:de:hbz:38-683736
DOI: 10.1136/rmdopen-2022-002639
Journal or Publication Title: RMD Open
Volume: 8
Number: 2
Date: 2022
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 2056-5933
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RHEUMATOID-ARTHRITISMultiple languages
RheumatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/68373

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