Methotrexate May Impair Immune Response to mRNA COVID-19 Vaccine

WEDNESDAY, May 26, 2021 (HealthDay News) — Patients with immune-mediated inflammatory diseases (IMIDs) receiving background methotrexate have worse humoral and cellular immunogenicity to mRNA COVID-19 vaccines, according to a study published online May 25 in the Annals of the Rheumatic Diseases.

Rebecca H. Haberman, M.D., from New York University Langone Health in New York City, and colleagues examined humoral and cellular immune responses to the BNT162b2 mRNA COVID-19 vaccine among 51 patients with IMID and 26 healthy controls from NYU Langone Health. The humoral immune response was also analyzed in a second, independent validation cohort of 182 controls and 31 patients with IMID from Germany.

The researchers found that healthy individuals and the 37 IMID patients on biologic treatments demonstrated robust antibody responses (>90 percent); however, only 62.2 percent of the 45 IMID patients on background methotrexate achieved an adequate response. After vaccination, there was no increase seen in CD8+ T cell activation in IMID patients.

“Taken together, our results suggest that the optimal protection of patients with IMID against COVID-19 will require further studies to determine whether additional doses of vaccine, dose modification of methotrexate, or even temporary discontinuation of this drug can boost immune response as has been demonstrated for other viral vaccines in this patient population,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Pfizer. The study was partially funded by the Pfizer COVID-19 Competitive Grant Program.

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