Waning humoral and cellular immunity after COVID-19 vaccination in patients with psoriasis treated with methotrexate and biologics: A cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Amanda Kvist-Hansen
  • Laura Pérez-Alós
  • Rownaq Fares Al-Sofi
  • Sebastian Rask Hamm
  • Dina Leth Møller
  • Mia Marie Pries-Heje
  • Kamille Fogh
  • Rasmus Bo Hasselbalch
  • Johannes Roth Madsen
  • Jose Juan Almagro Armenteros
  • Erik Sørensen
mRNA-based COVID-19 vaccines have short- and long-term efficacy in healthy individuals, but their efficacy in patients with psoriasis receiving immunomodulatory therapy is less studied.

To investigate long-term immunity after COVID-19 vaccination in patients with psoriasis receiving immunomodulatory therapy.

A prospective cohort study including patients (n = 123) with psoriasis receiving methotrexate (MTX) or biologics and controls (n = 226). Only mRNA-based COVID-19 vaccines administered with standard intervals between doses were investigated. Markers of immunity included SARS-CoV-2 spike glycoprotein-specific IgG and IgA, neutralizing capacity, and interferon-γ release from T cells stimulated with peptides of the SARS-CoV-2 spike glycoprotein.

The proportion of IgG responders was lower 6 months after vaccination in patients receiving anti-tumour necrosis factor (TNF) treatment compared with controls. Anti-TNF treatment was associated with lower IgG levels (β = −0.82, 95% confidence interval −1.38 to −0.25; P = 0.001). The median neutralizing index was lower in the anti-TNF group [50% inhibition (interquartile range [IQR] 37–89)] compared with controls [98% inhibition (IQR 96–99)]; P < 0.001. Cellular responses were numerically lowest in the anti-TNF group.

Treatment with anti-TNF has an impact on the immunity elicited by mRNA-based COVID-19 vaccination in patients with psoriasis, resulting in a faster waning of humoral and cellular markers of immunity; however, the clinical implications are unknown.
TidsskriftBritish Journal of Dermatology
Udgave nummer5
Sider (fra-til)661-669
Antal sider9
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by grants from the Carlsbergfondet Foundation (grant no. CF20-0045), the Novo Nordisk Fonden (grant no. NFF205A0063505 and grant no. NNF20SA0064201), the Svend Andersen Fonden (grant no. SARF2021), the Kongelig Hofbuntmager Aage Bangs Fond, the LEO Fondet, and the participating hospitals. The funders of the study had no role in the study design, data collection, data analysis or interpretation of data, in the writing of this paper and the decision to submit it for publication.

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved.

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