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Immunomodulators and risk for breakthrough infection after third COVID-19 mRNA vaccine among patients with rheumatoid

Abigail E Schiff1,2, Xiaosong Wang3, Naomi J Patel4,2

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115).

Medrxiv : the Preprint Server for Health Sciences
|October 24, 2023
PubMed
Abstract

Insights

Patients with rheumatoid arthritis (RA) on CD20 inhibitors or glucocorticoids face higher COVID-19 risks after three vaccine doses. These findings emphasize the need for targeted risk mitigation strategies for these vulnerable RA patient groups.

Area of Science:

  • Rheumatology
  • Immunology
  • Infectious Diseases

Background:

  • Rheumatoid arthritis (RA) patients often require immunomodulatory drugs.
  • The effectiveness of mRNA vaccines in RA patients, particularly after a third dose, requires further investigation regarding breakthrough infections.
  • Specific drug classes may influence vaccine response and infection risk.

Conclusions:

  • CD20 inhibitors and glucocorticoid monotherapy are identified as risk factors for breakthrough COVID-19 in RA patients post-third mRNA vaccine dose.
  • This study highlights the real-world impact of diminished immune responses in specific RA patient subgroups.
  • Effective risk mitigation strategies are crucial for RA patients on these immunomodulatory therapies to prevent severe COVID-19 outcomes.
Keywords:
COVID-19epidemiologyimmunosuppressionreinfection

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