Lupus May Lower COVID-19 Vaccine Antibody Response

Patients with systemic lupus erythematosus (SLE), irrespective of background immunosuppressive therapy, had lower antibody response levels to the SARS–CoV-2 vaccine, according to the findings of a recent study.

“The risk of COVID-19 infection is increased in patients with SLE versus those without SLE. Furthermore, some immunosuppressive medications increase COVID-19 infection and decrease the efficacy of vaccination,” the authors noted.

For the prospective cohort study, the researchers included 334 patients with SLE from the Hopkins Lupus Cohort, to compare with 1,887 healthy controls. The primary outcomes included SARS–CoV-2 antibody immunoglobulin (IgG) levels after vaccination in both cohorts and effect of immunosuppressive medications on postvaccination IgG levels in the SLE cohort.

In the SLE cohort, 92% were women, 51% were White, and 59% had received the Pfizer vaccine. In the healthy cohort, 80% were women, 90% were White and 81% had received Pfizer vaccine.

All SLE patients, regardless of whether they received immunosuppressive therapy, had lower levels of vaccine IgG than health care workers. Those treated with mycophenolate, tacrolimus, and belimumab, had significantly reduced response to the vaccine.

Withholding mycophenolate for 1 week after vaccination “increased postvaccine IgG levels significantly without leading to clinical flares,” the study concluded.

Reference:
Petri M, Joyce D, Haag K et al. Effect of systemic lupus erythematosus and immunosuppressive agents on COVID-19 vaccination antibody response. Arthritis Care Res. 2023: 75; 1878-1885. DOI: https://doi.org/10.1002/acr.25094