| Autor: |
Andrea Picchianti-Diamanti, Assunta Navarra, Alessandra Aiello, Bruno Laganà, Gilda Cuzzi, Andrea Salmi, Valentina Vanini, Fabrizio Maggi, Silvia Meschi, Giulia Matusali, Stefania Notari, Chiara Agrati, Simonetta Salemi, Roberta Di Rosa, Damiano Passarini, Valeria Di Gioia, Giorgio Sesti, Fabrizio Conti, Francesca Romana Spinelli, Angela Corpolongo, Maria Sole Chimenti, Mario Ferraioli, Gian Domenico Sebastiani, Maurizio Benucci, Francesca Li Gobbi, Anna Paola Santoro, Andrea Capri, Vincenzo Puro, Emanuele Nicastri, Delia Goletti |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Vaccines, Vol 11, Iss 11, p 1684 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2076-393X |
| DOI: |
10.3390/vaccines11111684 |
| Popis: |
Objectives: We aimed to analyse the incidence and severity of breakthrough infections (BIs) in rheumatoid arthritis (RA) patients after a COronaVIrus Disease 2019 (COVID-19) vaccination booster dose. Methods: We enrolled 194 RA patients and 1002 healthcare workers (HCWs) as controls. Clinical, lifestyle and demographic factors were collected at the time of the third dose, and immunogenicity analyses were carried out in a subgroup of patients at 4–6 weeks after the third dose. Results: BIs were experienced by 42% patients (82/194) with a median time since the last vaccination of 176 days. Older age (>50 years; aHR 0.38, 95% CI: 0.20–0.74), receiving conventional synthetic disease modifying antirheumatic drugs (csDMARDs) (aHR 0.52, 95%CI: 0.30–0.90) and having a titre of neutralising antibodies >20 (aHR 0.36, 95% CI: 0.12–1.07) were identified as protective factors. Conversely, anti-IL6R treatment and anti-CD20 therapy increased BI probability. BIs were mostly pauci-symptomatic, but the hospitalisation incidence was significantly higher than in HCWs (8.5% vs. 0.19%); the main risk factor was anti-CD20 therapy. Conclusions: Being older than 50 years and receiving csDMARDs were shown to be protective factors for BI, whereas anti-IL6R or anti-CD20 therapy increased the risk. Higher neutralising antibody titres were associated with a lower probability of BI. If confirmed in a larger population, the identification of a protective cut-off would allow a personalised risk–benefit therapeutic management of RA patients. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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