Key clinical point: A longer interval between rituximab infusion and SARS-CoV-2 vaccine may elicit an optimal response in patients with rheumatoid arthritis (RA) taking rituximab, with a third vaccination dose given 6-9 months after rituximab, boosting the cellular response despite the absence of a noticeable serological response.
Major finding: The median time between the last rituximab infusion and the first vaccination dose was significantly longer in responders vs. nonresponders (267 days vs. 107 days; P < .0001). A third vaccine dose in patients with insufficient serological response to 2 doses induced T-cell responses in all patients assessed, despite serological response in only 16.3% of patients. No serious adverse events or deaths were reported.
Study details: A prospective cohort study, Nor-vaC included patients with RA taking rituximab (n = 90) and healthy controls (n = 1,114) who received 2 or 3 doses of SARS-CoV-2 vaccines.
Disclosures: The study was funded by the Coalition for Epidemic Preparedness Innovations, Research Council of Norway COVID, and others. Several authors reported receiving speaker/consulting fees or grants/financial support from various sources.
Source: I Jyssum et al. Lancet Rheumatol. 2021 (Dec 23). Doi: 10.1016/S2665-9913(21)00394-5.