在系统性自身免疫性风湿性疾病患者中,Tixagevimab/Cilgavimab后的COVID-19突破
Yumeko Kawano1, Xiaosong Wang2, Naomi J Patel3
1Y. Kawano, MD, A.H. Jonsson, MD, PhD, J.A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, and Harvard Medical School.
The Journal of rheumatology
|October 15, 2023
概括
患有系统性自身免疫性类风湿性疾病 (SARDs) 的患者在 tixagevimab/cilgavimab 后经常经历COVID-19 的突破. 以前的幽默免疫提供了保护,但DMARD类型没有影响突破风险.
科学领域:
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- 系统性自身免疫性类风湿性疾病 (SARDs) 会增加对感染的易感性.
- 使用tixagevimab/cilgavimab的暴露前预防 (PrEP) 旨在在高风险人群中预防COVID-19.
- 了解突破性感染对于在SARD患者中管理COVID-19至关重要.
研究的目的:
- 为了确定突破COVID-19在SARDs患者中获得tixagevimab/cilgavimab的发生率.
- 为了确定与突破COVID-19后PrEP相关的基线因素.
- 评估疾病修饰性抗风湿性药物 (DMARD) 类型对突破风险的影响.
主要方法:
- 对444名接受了tixagevimab/cilgavimab.的SARD患者进行了回顾性队列研究.
- 主要结果:突破性的COVID-19.
- 多变量考克斯回归模型分析了风险因素,包括基线高峰抗体水平和DMARD使用.
主要成果:
- 突破COVID-19发生在18.7%的患者中 (发生率为31.5/1000人/月).
- 年龄较大与突破性感染相反相关.
- 较高的基线尖峰抗体水平与突破风险降低相关;使用CD20抑制剂显示风险与传统DMARD相似.
结论:
- 服用西沙吉维玛/西尔加维玛的SARS患者经常经历COVID-19的突破,尽管严重的结果很少见.
- 之前的幽默免疫是对突破性感染的保护.
- 预防严重的COVID-19,特别是随着PrEP疗法的发展,多式联络战略至关重要.
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