Rituximab, but not other biologics, impairs humoral immunity in patients with rheumatoid arthritis - a study using CoVariant protein arrays

Wei Hsun Lin, Pin Xian Du, Pei Shan Tsai, Batuhan Birol Keskin, Wen Yu Su, Nan Yao Lee, Wen Chien Ko, Pei Chun Lin, Hsi Chang Shih, Meng Yu Weng, Guan Da Syu

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: RA is an autoimmune disease characterized by chronic inflammation and joint destruction. Biologics are crucial to achieving treat-to-target goals in patients with RA. The global spread and continuous variation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitate the monitoring of variant-specific humoral responses post-vaccination. The aim of this study was to investigate how different biologic treatments for vaccinated RA patients might affect their neutralizing antibodies against multiple SARS-CoV-2 variants. Methods: We recruited RA patients who had received three doses of conventional SARS-CoV-2 vaccines and were treated with various biologics, e.g. TNF inhibitor (etanercept), IL-6 inhibitor (tocilizumab), CTLA4-Ig (abatacept) or anti-CD20 (rituximab). Serum samples were used to profile the binding and neutralizing antibodies using our own SARS-CoV-2 variant (CoVariant) protein array, developed previously. Results: Compared with healthy controls, only RA therapy with rituximab showed a reduction in neutralizing antibodies capable of targeting spike proteins in SARS-CoV-2 wild-type and most variants. This reduction was not observed in binding antibodies against SARS-CoV-2 wild-type or its variants. Conclusion: After receiving three doses of SARS-CoV-2 vaccination, RA patients who underwent rituximab treatment generated sufficient antibodies but exhibited lower neutralizing activities against wild-type and multiple variants, including current Omicron. Other biological DMARDs, e.g. TNF inhibitor, IL-6 inhibitor and CTLA4-Ig, did not show obvious inhibition.

Original languageEnglish
Article numberrkad085
JournalRheumatology Advances in Practice
Volume7
Issue number3
DOIs
Publication statusPublished - 2023

All Science Journal Classification (ASJC) codes

  • Rheumatology

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