Immunomodulators and risk for breakthrough COVID-19 after third SARS-CoV-2 mRNA vaccine among patients with rheumatoid arthritis: a cohort study

The US Centers for Disease Control and Prevention (CDC) recommends three SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine doses, rather than two, to complete the initial vaccine series for immunosuppressed patients. However, they may remain at risk for breakthrough COVID-19 due to immunomodulators that blunt vaccine responses.1 Identifying patients at highest risk for breakthrough COVID-19 can prioritise resources for prevention. Therefore, we investigated the risk of breakthrough COVID-19 among fully vaccinated patients with rheumatoid arthritis (RA) using disease-modifying antirheumatic drugs (DMARDs) and/or glucocorticoids, hypothesising that CD20 inhibitor (CD20i) users would have higher breakthrough COVID-19 risk than tumour necrosis factor inhibitor (TNFi) users. We performed a retrospective cohort study investigating immunomodulators and breakthrough COVID-19 risk among patients with RA who received three mRNA vaccines at Mass General Brigham, a multicentre healthcare system in Boston, Massachusetts, USA. A previously validated algorithm was used to identify patients with RA (postive predictive...

Source: Annals of the Rheumatic Diseases - April 11, 2024 Category: Rheumatology Authors: Schiff, A. E., Wang, X., Patel, N. J., Kawano, Y., Hanberg, J. L., Kowalski, E. N., Cook, C. E., Vanni, K. M., Qian, G., Bade, K. J., Saavedra, A. A., Srivatsan, S., Williams, Z. K., Venkat, R. K., Wallace, Z. S., Sparks, J. A. Tags: ARD, COVID-19 Letter Source Type: research