Older Age, a High Titre of Neutralising Antibodies and Therapy with Conventional DMARDs Are Associated with Protection from Breakthrough Infection in Rheumatoid Arthritis Patients after the Booster Dose of Anti-SARS-CoV-2 Vaccine Article Swipe
Andrea Picchianti Diamanti
,
Assunta Navarra
,
Alessandra Aiello
,
Bruno Laganà
,
Gilda Cuzzi
,
Andrea Salmi
,
Valentina Vanini
,
Fabrizio Maggi
,
Silvia Meschi
,
Giulia Matusali
,
Stefania Notari
,
Chiara Agrati
,
Simonetta Salemi
,
Roberta Rosa
,
Damiano Passarini
,
Valeria Di Gioia
,
Giorgio Sesti
,
Fabrizio Conti
,
Francesca Romana Spinelli
,
Angela Corpolongo
,
Maria Sole Chimenti
,
Mario Ferraioli
,
Gian Domenico Sebastiani
,
Maurizio Benucci
,
Francesca Li Gobbi
,
Anna Paola Santoro
,
Andrea Capri
,
Vincenzo Puro
,
Emanuele Nicastri
,
Delia Goletti
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/vaccines11111684
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/vaccines11111684
Objectives: We aimed to analyse the incidence and severity of breakthrough infections (BIs) in rheumatoid arthritis (RA) patients after a COronaVIrus Disease 2019 (COVID-19) vaccination booster dose. Methods: We enrolled 194 RA patients and 1002 healthcare workers (HCWs) as controls. Clinical, lifestyle and demographic factors were collected at the time of the third dose, and immunogenicity analyses were carried out in a subgroup of patients at 4–6 weeks after the third dose. Results: BIs were experienced by 42% patients (82/194) with a median time since the last vaccination of 176 days. Older age (>50 years; aHR 0.38, 95% CI: 0.20–0.74), receiving conventional synthetic disease modifying antirheumatic drugs (csDMARDs) (aHR 0.52, 95%CI: 0.30–0.90) and having a titre of neutralising antibodies >20 (aHR 0.36, 95% CI: 0.12–1.07) were identified as protective factors. Conversely, anti-IL6R treatment and anti-CD20 therapy increased BI probability. BIs were mostly pauci-symptomatic, but the hospitalisation incidence was significantly higher than in HCWs (8.5% vs. 0.19%); the main risk factor was anti-CD20 therapy. Conclusions: Being older than 50 years and receiving csDMARDs were shown to be protective factors for BI, whereas anti-IL6R or anti-CD20 therapy increased the risk. Higher neutralising antibody titres were associated with a lower probability of BI. If confirmed in a larger population, the identification of a protective cut-off would allow a personalised risk–benefit therapeutic management of RA patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/vaccines11111684
- https://www.mdpi.com/2076-393X/11/11/1684/pdf?version=1699015334
- OA Status
- gold
- Cited By
- 6
- References
- 58
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388304699
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388304699Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3390/vaccines11111684Digital Object Identifier
- Title
-
Older Age, a High Titre of Neutralising Antibodies and Therapy with Conventional DMARDs Are Associated with Protection from Breakthrough Infection in Rheumatoid Arthritis Patients after the Booster Dose of Anti-SARS-CoV-2 VaccineWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-02Full publication date if available
- Authors
-
Andrea Picchianti Diamanti, Assunta Navarra, Alessandra Aiello, Bruno Laganà, Gilda Cuzzi, Andrea Salmi, Valentina Vanini, Fabrizio Maggi, Silvia Meschi, Giulia Matusali, Stefania Notari, Chiara Agrati, Simonetta Salemi, Roberta Rosa, Damiano Passarini, Valeria Di Gioia, Giorgio Sesti, Fabrizio Conti, Francesca Romana Spinelli, Angela Corpolongo, Maria Sole Chimenti, Mario Ferraioli, Gian Domenico Sebastiani, Maurizio Benucci, Francesca Li Gobbi, Anna Paola Santoro, Andrea Capri, Vincenzo Puro, Emanuele Nicastri, Delia GolettiList of authors in order
- Landing page
-
https://doi.org/10.3390/vaccines11111684Publisher landing page
- PDF URL
-
https://www.mdpi.com/2076-393X/11/11/1684/pdf?version=1699015334Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://www.mdpi.com/2076-393X/11/11/1684/pdf?version=1699015334Direct OA link when available
- Concepts
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Medicine, Rheumatoid arthritis, Internal medicine, Incidence (geometry), Vaccination, Booster dose, Population, Antibody, Immunology, Titer, Environmental health, Optics, PhysicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 2, 2024: 4Per-year citation counts (last 5 years)
- References (count)
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58Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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