SARS-CoV-2 Vaccine Seroconversion in Patients With Hidradenitis Suppurativa Receiving Anti-TNF Therapy

Tumour necrosis factor-α (TNF-α) inhibitors such as adalimumab and infliximab are commonly used in moderate-to-severe hidradenitis suppurativa (HS). While the impact of TNF-α inhibitors on outcomes after an active infection in patients with HS has been explored, their effect on the SARS-CoV-2 vaccine response remains unknown. We investigated the impact of TNF-α inhibitor therapy on the immunogenic response to the SARS-CoV-2 vaccine in patients with HS.

This is a single-centre retrospective chart review of 120 patients with recorded levels of anti-SARS-CoV-2 spike antibody. This cohort was characterized descriptively by demographics, antibody levels, vaccine brand, number of doses, and days elapsed from vaccination. These variables were then compared by usage of anti-TNF therapy. Secondary analyses included comparison by biologic type, time on biologic, and biologic dosage.

We found no significant difference in seroconversion following SARS-CoV-2 vaccination while on anti-TNF therapy in HS patients; a finding that holds in comparisons between anti-TNF therapy type, time exposed to biologic, and anti-TNF dosage.

Patients with HS on anti-TNF therapy receiving the SARS-CoV-2 mRNA vaccine seroconvert similarly as those without anti-TNF therapy, indicating this population should receive the vaccine and expect a similar degree of protection against COVID-19 compared to HS patients who do not receive anti-TNF therapy.