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ACR: Lupus Patients Can Have Low Immune Response to COVID-19 Vaccines

However, overall disease activity does not appear to change after vaccination

MONDAY, Nov. 15, 2021 (HealthDay News) — Nearly one-third of systemic lupus erythematosus (SLE) patients have a low response to the COVID-19 vaccine, according to a study presented at the annual meeting of the American College of Rheumatology, held virtually from Nov. 3 to 9.

Peter M. Izmirly, M.D., from NYU Langone Health in New York City, and colleagues evaluated seroreactivity and disease flares after COVID-19 vaccination in a multiethnic/racial cohort of patients with SLE. The analysis included 90 patients with SLE and 20 controls.

The researchers found that the mean titers of postvaccination antibody levels were lower in SLE patients versus controls. Nearly three in 10 SLE patients (29 percent) generated immunoglobulin (Ig)G antibody responses to the severe acute respiratory syndrome coronavirus 2 Spike receptor-binding domain that fell below that of the lowest response obtained for the controls. Among SLE patients, predictors of ELISA response included taking antimalarials or no medications (odds ratio, 11.8) and elevated anti-dsDNA prior to vaccination (odds ratio, 7.8). Among a subset of patients with poor antibody responses, interferon-γ production was also diminished. Overall, there was no change noted in postvaccination SLE disease activity index scores versus those measured before vaccination. Overall, 11 percent of patients had postvaccination disease flares, with only 1 percent reaching a severe flare.

“Our data and that of other groups suggest that certain medications or combinations of medications could affect the efficacy of the vaccines,” Izmirly said in a statement. “While minimal protective levels remain unknown, these data suggest protocol development is needed to assess efficacy of booster vaccination.”

Several authors disclosed financial ties to the pharmaceutical industry.

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