» Articles » PMID: 38291047

Beneficial Effect of Temporary Methotrexate Interruption on B and T Cell Responses Upon SARS-CoV-2 Vaccination in Patients with Rheumatoid Arthritis or Psoriatic Arthritis

Abstract

B and T cell responses were evaluated in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) after 1 or 2 weeks of methotrexate (MTX) withdrawal following each COVID-19 vaccine dose and compared with those who maintained MTX. Adult RA and PsA patients treated with MTX were recruited and randomly assigned to 3 groups: MTX-maintenance (n = 72), MTX-withdrawal for 1 week (n = 71) or MTX-withdrawal for 2 weeks (n = 73). Specific antibodies to several SARS-CoV-2 antigens and interferon (IFN)-γ and interleukin (IL)-21 responses were assessed. MTX withdrawal in patients without previous COVID-19 was associated with higher levels of anti-RBD IgG and neutralising antibodies, especially in the 2-week withdrawal group and with higher IFN-γ secretion upon stimulation with pools of SARS-CoV-2 S peptides. No increment of RA/PsA relapses was detected across groups. Our data indicate that two-week MTX interruption following COVID-19 vaccination in patients with RA or PsA improves humoral and cellular immune responses.

Citing Articles

Severe Respiratory Infections in Rheumatoid Arthritis Patients: An Observational Study of 528 Patients from a Single University Hospital.

Dominguez-Casas L, Ferraz-Amaro I, Castaneda S, Blanco R J Clin Med. 2025; 14(4).

PMID: 40004702 PMC: 11856632. DOI: 10.3390/jcm14041174.


Methotrexate treatment hampers induction of vaccine-specific CD4 T cell responses in patients with IMID.

Kummer L, Blanco L, Kreher C, Bos A, Kuijper L, Verstegen N RMD Open. 2024; 10(4).

PMID: 39375177 PMC: 11459311. DOI: 10.1136/rmdopen-2024-004664.


Effectiveness and Safety of the COVID-19 Vaccine in Patients with Rheumatoid Arthritis in a Real-World Setting.

Torres-Rufas M, Vicente-Rabaneda E, Cardenoso L, Gutierrez A, Bong D, Valero-Martinez C Vaccines (Basel). 2024; 12(6).

PMID: 38932401 PMC: 11209506. DOI: 10.3390/vaccines12060672.

References
1.
van der Maas A, Lie E, Christensen R, Choy E, de Man Y, van Riel P . Construct and criterion validity of several proposed DAS28-based rheumatoid arthritis flare criteria: an OMERACT cohort validation study. Ann Rheum Dis. 2012; 72(11):1800-5. DOI: 10.1136/annrheumdis-2012-202281. View

2.
Ettinger R, Sims G, Fairhurst A, Robbins R, da Silva Y, Spolski R . IL-21 induces differentiation of human naive and memory B cells into antibody-secreting plasma cells. J Immunol. 2005; 175(12):7867-79. DOI: 10.4049/jimmunol.175.12.7867. View

3.
Yi J, Du M, Zajac A . A vital role for interleukin-21 in the control of a chronic viral infection. Science. 2009; 324(5934):1572-6. PMC: 2736049. DOI: 10.1126/science.1175194. View

4.
Cordtz R, Lindhardsen J, Soussi B, Vela J, Uhrenholt L, Westermann R . Incidence and severeness of COVID-19 hospitalization in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark. Rheumatology (Oxford). 2020; 60(SI):SI59-SI67. PMC: 7798558. DOI: 10.1093/rheumatology/keaa897. View

5.
Park J, Lee Y, Shin K, Ha Y, Lee E, Song Y . Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis. 2018; 77(6):898-904. PMC: 5965360. DOI: 10.1136/annrheumdis-2018-213222. View