甲索和瘤坏死因子抑制剂在SARS-CoV-2疫苗接种后独立降低中和抗体:SUCCEED研究的最新结果
Carol A Hitchon1, Dawn M E Bowdish2, Gilles Boire3
1Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
Vaccines
|September 28, 2024
概括
瘤坏死因子抑制剂 (TNFi) 和甲状腺素独立地降低了在免疫媒介炎症疾病 (IMID) 患者接种COVID-19疫苗后的SARS-CoV-2中和. 这凸显了在这个脆弱人群中需要优化疫苗接种策略的需要.
科学领域:
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
- 类风湿病学 类风湿病学
背景情况:
- 严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 仍然是死亡的重要原因.
- 患有免疫媒介炎症疾病 (IMID) 的患者经常接受免疫抑制疗法,可能会影响疫苗的疗效.
- 了解特定治疗对疫苗反应的影响对于管理IMID人群感染疾病风险至关重要.
研究的目的:
- 在IMID患者中调查甲状腺和瘤亡因子抑制剂 (TNFi) 对SARS-CoV-2中和反应在COVID-19疫苗接种后的影响.
- 量化这些药物对抗体中和对不同SARS-CoV-2菌株的独立影响.
主要方法:
- 在加拿大六个学术中心从479名患有各种IMID (IBD,RA,PsA,SpA,SLE) 的成年人收集血清.
- 使用来自两个时间点的血清对祖先SARS-CoV-2菌株和Omicron变种 (BA1,BA5) 的中和能力的评估.
- 采用多变量通用逻辑模型和随机效应元分析来评估甲索和TNFi效应的调整赔率比率.
主要成果:
- 这两种TNFi和甲甲酸盐都独立地与SARS-CoV-2中和反应的减弱有关.
- 分析显示,对TNFi的调整后几率比为0.56 (95% CI 0.39,0.81) 对于祖先菌株和BA5.5.
- 分析显示,BA1菌株的甲索特雷克萨特调整后几率比为0.39 (95% CI 0.19,0.76).
结论:
- 接种了TNFi或甲状腺素治疗的IMID疫苗的个体表现出SARS-CoV-2中和性的降低.
- 这些发现强调需要持续警和优化IMID患者的COVID-19疫苗接种策略.
- 进一步的研究可能会探索免疫抑制群体的替代或增强疫苗接种方案.
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