在一项随机对照试验中,在接受免疫抑制剂治疗的患有自身免疫性疾病的个体中进行潜在的SARS-CoV-2额外接种疫苗
Meggan Mackay1, Catriona A Wagner2, Ashley Pinckney3
1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America.
JCI insight
|November 25, 2025
概括
额外的COVID-19疫苗可以促进自身免疫疾病患者的抗体反应,这些患者接受了MMF/MPA和MTX等免疫抑制剂. 在接种疫苗期间保留这些药物并没有影响疗效或安全性,但对免疫功能低下的人来说有好处.
科学领域:
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
- 类风湿病学 类风湿病学
背景情况:
- 患有自身免疫性疾病 (AD) 的人通常对标准的COVID-19疫苗接种方案表现出降低的免疫反应.
- 免疫抑制疗法,包括mycophenolate mofetil/mycophenolic acid (MMF/MPA),methotrexate (MTX) 和B细胞消耗疗法 (BCDT),进一步损害了AD患者的疫苗疗效.
研究的目的:
- 在接受免疫抑制剂的AD患者中评估额外的COVID-19疫苗剂量的疗效和安全性.
- 调查暂时保留MMF/MPA和MTX对疫苗反应和安全的影响.
主要方法:
- 一个开放的,多中心的,随机的试验,涉及22名MMF/MPA,26名MTX和93名BCDT参与者,他们的抗体反应低于最佳水平.
- 参与者接受了额外的同源COVID-19疫苗剂量.
- 随机分配MMF/MPA和MTX组,在接种疫苗时继续或暂停治疗;主要结局是4周后抗RBD抗体度的变化.
主要成果:
- 额外的疫苗接种在MMF/MPA和MTX组中显著增加了抗RBD抗体度,而不管是否停止治疗.
- 接受BCDT治疗的参与者也显示抗RBD水平增加,尽管低于其他组.
- 在33%的参与者中发生了COVID-19,主要是轻度病例,少有住院治疗;额外的疫苗接种被很好地容忍,不良反应和疾病爆发很低.
结论:
- 额外的COVID-19疫苗剂量对于服用免疫抑制剂的阿尔茨海默病患者是有效和安全的.
- 在接种疫苗期间不需要保留MMF/MPA或MTX,以实现有益的免疫反应.
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