Evidence map›Paper›PMID 37076360›Full record

ArticleVaccine2023

The impact of immunomodulating treatment on the immunogenicity of COVID-19 vaccines in patients with immune-mediated inflammatory rheumatic diseases compared to healthy controls. A Swedish nationwide study (COVID19-REUMA).

Martina Frodlund, Per Nived, Aikaterini Chatzidionysiou, Anna Södergren, Eva Klingberg, Anders Bengtsson, Monika Hansson, Sophie Olsson, Elisa Pin, Lars Klareskog and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Vaccine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Vaccination Update and Specific Concerns for RA.Current rheumatology reports · 2025
    Review
  3. Article
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Martina FrodlundDepartment of Biomedical and Clinical Sciences, Division of Inflammation and Infection/Rheumatology, Linköping University, Linköping, Sweden.
Per NivedCentral Hospital in Kristianstad, Department of Infectious Diseases and Department of Clinical Sciences, Section for Rheumatology, Lund University, Lund, Sweden; Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden.
Aikaterini ChatzidionysiouDepartment of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital at Karolinska Institutet, Stockholm, Sweden.
Anna SödergrenDepartment of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden; Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden.
Eva KlingbergDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Anders BengtssonDepartment of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden.
Monika HanssonDepartment of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital at Karolinska Institutet, Stockholm, Sweden.
Sophie OlssonDepartment of Clinical Sciences, Lund, Section for Nephrology, Lund University, Lund and Skåne University Hospital, Lund, Sweden.
Elisa PinDepartment of Protein Science, SciLifeLab, KTH Royal Institute of Technology, Stockholm, Sweden.
Lars KlareskogDepartment of Medicine, Solna, Division of Rheumatology, Karolinska University Hospital at Karolinska Institutet, Stockholm, Sweden.
Meliha C KapetanovicDepartment of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden. Electronic address: meliha.c_kapetanovic@med.lu.se.
Lund University · SEKarolinska University Hospital · SELinköping University · SEScience for Life Laboratory · SEUmeå University · SEUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo elucidate antibody responses after the second and third dose of COVID-19 vaccine in patients with inflammatory rheumatic diseases (IRD) treated with biologic/targeted disease modifying anti-rheumatic drugs (b/ts DMARDs).

methodsAntibody levels to antigens representing spike full length protein and spike S1 were measured before vaccination, 2-12 weeks after the second dose, before and after the third dose using multiplex bead-based serology assay. Positive antibody response was defined as antibody levels over cut off (seropositivity) in seronegative individuals or ≥ 4-fold increase in antibodies in individuals seropositive for both spike proteins.

resultsPatients (n = 414) receiving b/ts DMARDs (283 had arthritis, 75 systemic vasculitis and 56 other autoimmune diseases) and controls (n = 61) from five Swedish regions participated. Treatments groups were: rituximab (n = 145); abatacept (n = 22); Interleukin 6 receptor inhibitors [IL6i (n = 79)]; JAnus Kinase Inhibitors [JAKi (n = 58)], Tumour Necrosis Factor inhibitor [TNFi (n = 68)] and Interleukin12/23/17 inhibitors [IL12/23/17i (n = 42)]. Percentage of patients with positive antibody response after two doses was significantly lower in rituximab (33,8%) and abatacept (40,9%) (p < 0,001) but not in IL12/23/17i, TNFi or JAKi groups compared to controls (80,3%). Higher age, rituximab treatment and shorter time between last rituximab course and vaccination predicted impaired antibody response. Antibody levels collected 21-40 weeks after second dose decreased significantly (IL6i: p = 0,02; other groups: p < 0,001) compared to levels at 2-12 week but most participants remained seropositive. Proportion of patients with positive antibody response increased after third dose but was still significantly lower in rituximab (p < 0,001).

conclusionsOlder individuals and patients on maintenance rituximab have an impaired response after two doses of COVID-19 vaccine which improves if the time between last rituximab course and vaccination extends and also after an additional vaccine dose. Rituximab patients should be prioritized for booster vaccine doses. TNFi, JAKi and IL12/23/17i does not diminished humoral response to primary and an additional vaccination.

Indexed as

Antirheumatic AgentsCOVID-19Rheumatic DiseasesAbataceptAntibodies, ViralCOVID-19 VaccinesHumansInterleukin-12RituximabSwedenAbataceptAntibodies, ViralAntirheumatic AgentsCOVID-19 VaccinesInterleukin-12RituximabAbataceptAntibody responseCOVID-19 vaccineImmunogenicityInflammatory rheumatic diseaseMethotrexateRituximab

Identifiers

PMID37076360
PMCPMC10070777
OpenAlexW4362524675

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.