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2. Chronic kidney disease in patients with childhood-onset systemic lupus erythematosus

Author

Sakamoto, Ana P., Silva, Clovis A., Islabão, Aline G., Novak, Glaucia V., Molinari, Beatriz, Nogueira, Paulo K., Pereira, Rosa M. R., Saad-Magalhães, Claudia, Clemente, Gleice, Piotto, Daniela P., Aikawa, Nadia E., Pitta, Ana C., Trindade, Vitor C., Appenzeller, Simone, Carvalho, Luciana M., Rabelo-Junior, Carlos N., Fonseca, Adriana R., Sztajnbok, Flavio R., Santos, Maria C., Bica, Blanca E., Sena, Evaldo G., Moraes, Ana J., Fraga, Melissa M., Robazzi, Teresa C., Spelling, Paulo F., Scheibel, Iloite M., Cavalcanti, Andre S., Matos, Erica N., Guimarães, Luciano J., Santos, Flavia P., Mota, Licia M. H., Bonfá, Eloisa, and Terreri, Maria T.

Published
2023
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3. Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic

Author

Campos, Reinan T., Lindoso, Livia, Sousa, Renan A. de, Helito, Alberto C., Ihara, Bianca P., Strabelli, Claudia A.A., Paradelas, Levi M.V., Carneiro, Beatriz O.L., Cardoso, Maria Paula R., Souza, Jean Paulo V. de, Freire, Marianna R. de M., Astley, Camilla, Laurentino, Moisés F., Buscatti, Izabel M., Kozu, Katia, Aikawa, Nadia E., Sallum, Adriana M.E., Ferreira, Juliana C.O., Simon, Juliana R., Viana, Vivianne S.L., Queiroz, Ligia B., Gualano, Bruno, Roschel, Hamilton, Pereira, Rosa Maria R., Toma, Ricardo K., Watanabe, Andréia, Grangeiro, Patricia M., Casella, Caio B., Farhat, Sylvia C., Polanczyk, Guilherme V., Campos, Lucia Maria A., and Silva, Clovis A.

Published
2023
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4. Anti-SARS-CoV-2 inactivated vaccine in patients with ANCA-associated vasculitis: Immunogenicity, safety, antibody decay and the booster dose

Author

Pereira, Rosa M.R., Dagostin, Marilia A., Caparbo, Valeria F., Sales, Lucas P., Pasoto, Sandra G., Silva, Clovis A., Yuki, Emily F.N., Saad, Carla G.S., Medeiros-Ribeiro, Ana C., Kupa, Leonard V.K., Fusco, Solange R.G., Martins, Victor A.O., Martins, Carolina C.M.F., Barbas, Carmen Valente, Shinjo, Samuel K., Aikawa, Nadia E., and Bonfa, Eloisa

Published
2023
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5. Interaction of TNFi and conventional synthetic DMARD in SARS-CoV-2 vaccine response in axial spondyloarthritis and psoriatic arthritis

Author

G.S. Saad, Carla, S.R. Silva, Matheus, Sampaio-Barros, Perceval D., C.B. Moraes, Julio, G. Schainberg, Cláudia, Gonçalves, Celio R., Shimabuco, Andrea Y., Aikawa, Nadia E., F.N. Yuki, Emily, G. Pasoto, Sandra, V.K. Kupa, Leonard, K. Aoyama, Renato, S.R. Araujo, Carlo, Silva, Clóvis A., Medeiros-Ribeiro, Ana C., and Bonfa, Eloisa

Published
2023
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6. No Associations Between Physical Activity and Immunogenicity in SARS-CoV-2 Seropositive Patients With Autoimmune Rheumatic Diseases Prior to and After Vaccination.

Author

Smaira, Fabiana Infante, Mazzolani, Bruna Caruso, Lemes, Ítalo Ribeiro, da Silva, Rafael Pires, Pinto, Ana J., Sieczkowska, Sofia M., Aikawa, Nadia E., Pasoto, Sandra G., Medeiros-Ribeiro, Ana C., Saad, Carla G.S., Yuk, Emily F.N., Silva, Clovis A., Swinton, Paul, Kupa, Leonard de Vinci Kanda, Hallal, Pedro C., Roschel, Hamilton, Gualano, Bruno, and Bonfa, Eloisa

Subjects
IMMUNE response, RHEUMATISM, PHYSICAL activity, NATURAL immunity, SARS-CoV-2
Abstract

Aim: To investigate the association between physical activity and immunogenicity among SARS-CoV-2 seropositive patients with autoimmune rheumatic diseases prior to and following a 2-dose schedule of CoronaVac (Sinovac inactivated vaccine). Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial conducted in Sao Paulo, Brazil. In this substudy, only SARS-CoV-2 seropositive patients were included. Immunogenicity was assessed by seroconversion rates of total anti-SARS-CoV-2 S1/S2 immunoglobulin G (IgG), geometric mean titers of anti-S1/S2 IgG, frequency of positive neutralizing antibodies, and neutralizing activity before and after vaccination. Physical activity was assessed through a questionnaire. Model-based analyses were performed controlling for age (<60 or ≥60 y), sex, body mass index (<25, 25–30, and >30 kg/m2), and use of prednisone, immunosuppressants, and biologics. Results: A total of 180 seropositive autoimmune rheumatic disease patients were included. There was no association between physical activity and immunogenicity before and after vaccination. Conclusions: This study suggests that the positive association between physical activity and greater antibody responses seen in immunocompromised individuals following vaccination is overridden by previous SARS-CoV-2 infection, and does not extend to natural immunity. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Immunogenicity decay and case incidence six months post Sinovac-CoronaVac vaccine in autoimmune rheumatic diseases patients

Author

Silva, Clovis A., Medeiros-Ribeiro, Ana C., Kupa, Leonard V. K., Yuki, Emily F. N., Pasoto, Sandra G., Saad, Carla G. S., Fusco, Solange R. G., Pereira, Rosa M. R., Shinjo, Samuel K., Halpern, Ari S. R., Borba, Eduardo F., Souza, Fernando H. C., Guedes, Lissiane K. N., Miossi, Renata, Bonfiglioli, Karina R., Domiciano, Diogo S., Shimabuco, Andrea Y., Andrade, Danieli C. O., Seguro, Luciana P. C., Fuller, Ricardo, Sampaio-Barros, Percival D., Assad, Ana P. L., Moraes, Julio C. B., Goldenstein-Schainberg, Claudia, Giardini, Henrique A. M., Silva, Henrique C., Martins, Victor A. O., Villamarin, Lorena E. B., Novellino, Renata S., Sales, Lucas P., Araújo, Carlo S. R., Silva, Matheus S. R., Filho, Dilson M. N., Lopes, Marta H., Duarte, Alberto J. S., Kallas, Esper G., Aikawa, Nadia E., and Bonfa, Eloisa

Published
2022
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11. Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

Author

Gualano, Bruno, Lemes, Italo R., Silva, Rafael P., Pinto, Ana J., Mazzolani, Bruna C., Smaira, Fabiana I., Sieczkowska, Sofia M., Aikawa, Nadia E., Pasoto, Sandra G., Medeiros-Ribeiro, Ana C., Saad, Carla G.S., Yuki, Emily F.N., Silva, Clovis A., Swinton, Paul, Hallal, Pedro C., Roschel, Hamilton, and Bonfa, Eloisa

Published
2022
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12. Immunogenicity and safety of two doses of the CoronaVac SARS-CoV-2 vaccine in SARS-CoV-2 seropositive and seronegative patients with autoimmune rheumatic diseases in Brazil: a subgroup analysis of a phase 4 prospective study

Author

Aikawa, Nadia E, Kupa, Leonard V K, Pasoto, Sandra G, Medeiros-Ribeiro, Ana C, Yuki, Emily F N, Saad, Carla G S, Pedrosa, Tatiana, Fuller, Ricardo, Shinjo, Samuel K, Sampaio-Barros, Percival D, Andrade, Danieli C O, Pereira, Rosa M R, Seguro, Luciana P C, Valim, Juliana M L, Waridel, Filipe, Sartori, Ana Marli C, Duarte, Alberto J S, Antonangelo, Leila, Sabino, Ester C, Menezes, Paulo Rossi, Kallas, Esper G, Silva, Clovis A, and Bonfa, Eloisa

Published
2022
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14. Immunogenicity and safety of the CoronaVac inactivated vaccine in patients with autoimmune rheumatic diseases: a phase 4 trial

Author

Medeiros-Ribeiro, Ana C., Aikawa, Nadia E., Saad, Carla G. S., Yuki, Emily F. N., Pedrosa, Tatiana, Fusco, Solange R. G., and Rojo, Priscila T.

Subjects
Rheumatic diseases -- Diagnosis -- Care and treatment, Human immunogenetics -- Analysis, Biological sciences, Health, CoronaVac (Vaccine) -- Testing
Abstract

CoronaVac, an inactivated SARS-CoV-2 vaccine, has been approved for emergency use in several countries. However, its immunogenicity in immunocompromised individuals has not been well established. We initiated a prospective phase 4 controlled trial (no. NCT04754698, CoronavRheum) in 910 adults with autoimmune rheumatic diseases (ARD) and 182 age- and sex-frequency-matched healthy adults (control group, CG), who received two doses of CoronaVac. The primary outcomes were reduction of [greater than or equal to]15% in both anti-SARS-CoV-2 IgG seroconversion (SC) and neutralizing antibody (NAb) positivity 6 weeks (day 69 (D69)) after the second dose in the ARD group compared with that in the CG. Secondary outcomes were IgG SC and NAb positivity at D28, IgG titers and neutralizing activity at D28 and D69 and vaccine safety. Prespecified endpoints were met, with lower anti-SARS-Cov-2 IgG SC (70.4 versus 95.5%, P < 0.001) and NAb positivity (56.3 versus 79.3%, P < 0.001) at D69 in the ARD group than in the CG. Moreover, IgG titers (12.1 versus 29.7, P < 0.001) and median neutralization activity (58.7 versus 64.5%, P = 0.013) were also lower at D69 in patients with ARD. At D28, patients with ARD presented with lower IgG frequency (18.7 versus 34.6%, P < 0.001) and NAb positivity (20.6 versus 36.3%, P < 0.001) than that of the CG. There were no moderate/severe adverse events. These data support the use of CoronaVac in patients with ARD, suggesting reduced but acceptable short-term immunogenicity. The trial is still ongoing to evaluate the long-term effectiveness/immunogenicity. In a large prospective phase 4 trial, vaccination with CoronaVac, an inactivated SARS-CoV-2 vaccine, elicited significantly lower virus-specific IgG antibodies and neutralizing antibodies in patients with autoimmune rheumatic diseases than in age- and sex-matched healthy control trial participants., Author(s): Ana C. Medeiros-Ribeiro [sup.1] , Nadia E. Aikawa [sup.1] [sup.2] , Carla G. S. Saad [sup.1] , Emily F. N. Yuki [sup.1] , Tatiana Pedrosa [sup.1] , Solange R. [...]

Published
2021
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18. Physical Activity: A Strategy to Improve Antibody Response to a SARS-CoV-2 Vaccine Booster Dose in Patients With Autoimmune Rheumatic Diseases.

Author

Gualano, Bruno, Sieczkowska, Sofia M., Lemes, Ítalo Ribeiro, da Silva, Rafael Pires, Pinto, Ana J., Mazzolani, Bruna C., Smaira, Fabiana I., Aikawa, Nadia E., Kupa, Leonard V.K., Pasoto, Sandra G., Medeiros-Ribeiro, Ana C., Saad, Carla G.S., Yuk, Emily F.N., Silva, Clovis A., Swinton, Paul, Hallal, Pedro C., Roschel, Hamilton, and Bonfa, Eloisa

Subjects
BOOSTER vaccines, COVID-19 vaccines, RHEUMATISM, ANTIBODY formation, PHYSICAL activity, HIV seroconversion
Abstract

Background: Physical activity associates with improved immunogenicity following a 2-dose schedule of CoronaVac (Sinovac's inactivated SARS-CoV-2 vaccine) in patients with autoimmune rheumatic diseases (ARD). This study evaluates whether physical activity impacts vaccine-induced antibody responses to a booster dose in this population. Methods: This was a phase-4 trial conducted in São Paulo, Brazil. Patients with ARD underwent a 3-dose schedule of CoronaVac. One month after the booster, we assessed seroconversion rates of anti-SARS-CoV-2 S1/S2 IgG, geometric mean titers of anti-S1/S2 IgG, frequency of positive neutralizing antibodies, and neutralizing activity. Physical activity was assessed through questionnaire. Results: Physically active (n = 362) and inactive (n = 278) patients were comparable for most characteristics; however, physically active patients were younger (P <.01) and had a lower frequency of chronic inflammatory arthritis (P <.01). Adjusted models showed that physically active patients had ∼2 times odds of seroconversion rates (OR: 2.09; 95% confidence interval, 1.22 to 3.61), ∼22% greater geometric mean titers of anti-S1/S2 IgG (22.09%; 95% confidence interval, 3.91 to 65.60), and ∼7% greater neutralizing activity (6.76%; 95% confidence interval, 2.80 to 10.72) than inactive patients. Conclusions: Patients with ARD who are physically active have greater odds of experiencing better immunogenicity to a booster dose of CoronaVac. These results support the recommendation of physical activity to improve vaccination responses, particularly for immunocompromised individuals. [ABSTRACT FROM AUTHOR]

Published
2023
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23. Food consumption based on processing level (according to Nova system) during the COVID-19 pandemic among adolescents with immunocompromised conditions: a case-control study

Author

Esteves, Gabriel P., primary, Mazzolani, Bruna Caruso, additional, Smaira, Fabiana Infante, additional, Santo André, Heloísa C., additional, Iraha, Amanda Yuri, additional, Astley, Camilla, additional, Marques, Isabela Gouveia, additional, Amarante, Milla Cordeiro, additional, Rezende, Nathalia Saffioti, additional, Sieczkowska, Sofia Mendes, additional, Franco, Tathiane Christine, additional, do Amaral Miranda, Luana Cristina, additional, Lindoso, Lívia, additional, Helito, Alberto Carame, additional, Oba, Jane, additional, Queiroz, Ligia Bruni, additional, Pereira, Rosa Maria R., additional, Campos, Lucia Maria A., additional, Aikawa, Nadia E., additional, Roschel, Hamilton, additional, Silva, Clovis A., additional, and Gualano, Bruno, additional

Published
2023
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24. Risk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patients

Author

Sakamoto, Ana P, primary, Silva, Clovis A, additional, Pita, Ana C, additional, Trindade, Vitor C, additional, Islabao, Aline G, additional, Fiorot, Fernanda J, additional, Lopes, Sandra RM, additional, Pereira, Rosa MR, additional, Saad-Magalhaes, Claudia, additional, Russo, Gleice CS, additional, Len, Claudio A, additional, Prado, Rogerio do, additional, Campos, Lucia MA, additional, Aikawa, Nadia E, additional, Appenzeller, Simone, additional, Ferriani, Virginia PL, additional, Silva, Marco F, additional, Felix, Marta, additional, Fonseca, Adriana R, additional, Assad, Ana PL, additional, Sztajnbok, Flavio R, additional, Santos, Maria C, additional, Bica, Blanca E, additional, Sena, Evaldo G, additional, Moraes, Ana J, additional, Fraga, Melissa M, additional, Robazzi, Teresa C, additional, Spelling, Paulo F, additional, Scheibel, Iloite M, additional, Cavalcanti, Andre S, additional, Matos, Erica N, additional, Guimaraes, Luciano J, additional, Santos, Flavia P, additional, Mota, Licia MH, additional, Bonfa, Eloisa, additional, and Terreri, Maria T, additional

Published
2023
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32. Autoimmune hepatitis in 847 childhood-onset systemic lupus erythematosus population: a multicentric cohort study

Author

Balbi, Verena A., Montenegro, Bárbara, Pitta, Ana C., Schmidt, Ana R., Farhat, Sylvia C., Coelho, Laila P., Ferreira, Juliana C. O., Pereira, Rosa M. R., Terreri, Maria T., Saad-Magalhães, Claudia, Aikawa, Nadia E., Sakamoto, Ana P., Kozu, Kátia, Campos, Lucia M., Sallum, Adriana M., Ferriani, Virginia P., Piotto, Daniela P., Bonfá, Eloisa, and Silva, Clovis A.

Published
2018
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33. Diffuse alveolar hemorrhage in childhood-onset systemic lupus erythematosus: a severe disease flare with serious outcome

Author

Blay, Gabriela, Rodrigues, Joaquim C., Ferreira, Juliana C. O., Leal, Gabriela N., Gormezano, Natali W., Novak, Glaucia V., Pereira, Rosa M. R., Terreri, Maria T., Magalhães, Claudia S., Molinari, Beatriz C., Sakamoto, Ana P., Aikawa, Nadia E., Campos, Lucia M. A., Fernandes, Taciana A. P., Clemente, Gleice, Peracchi, Octavio A. B., Bugni, Vanessa, Marini, Roberto, Sacchetti, Silvana B., Carvalho, Luciana M., Fraga, Melissa M., Castro, Tânia C. M., Ramos, Valéria C., Bonfá, Eloisa, Silva, Clovis A., and Brazilian Childhood-onset Systemic Lupus Erythematosus Group

Published
2018
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35. Supplemental Material - Risk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patients

Author

Sakamoto, Ana P, Silva, Clovis A, Pita, Ana C, Trindade, Vitor C, Islabao, Aline G, Fiorot, Fernanda J, Lopes, Sandra RM, Pereira, Rosa MR, Saad-Magalhaes, Claudia, Russo, Gleice CS, Len, Claudio A, Prado, Rogerio do, Campos, Lucia MA, Aikawa, Nadia E, Appenzeller, Simone, Ferriani, Virginia PL, Silva, Marco F, Felix, Marta, Fonseca, Adriana R, Assad, Ana PL, Sztajnbok, Flavio R, Santos, Maria C, Bica, Blanca E, Sena, Evaldo G, Moraes, Ana J, Fraga, Melissa M, Robazzi, Teresa C, Spelling, Paulo F, Scheibel, Iloite M, Cavalcanti, Andre S, Matos, Erica N, Guimaraes, Luciano J, Santos, Flavia P, Mota, Licia MH, Bonfa, Eloisa, and Terreri, Maria T

Subjects
111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material for Risk factors for mortality in 1528 Brazilian childhood-onset systemic lupus erythematosus patients by Ana P Sakamoto, Clovis A Silva, Ana C Pita, Vitor C Trindade, Aline G Islabao, Fernanda J Fiorot, Sandra RM Lopes, Rosa MR Pereira, Claudia Saad-Magalhaes, Gleice CS Russo, Claudio A Len, Rogerio do Prado, Lucia MA Campos, Nadia E Aikawa, Simone Appenzeller, Virginia PL Ferriani, Marco F Silva, Marta Felix, Adriana R Fonseca, Ana PL Assad, Flavio R Sztajnbok, Maria C Santos, Blanca E Bica, Evaldo G Sena, Ana J Moraes, Melissa M Fraga, Teresa C Robazzi, Paulo F Spelling, Iloite M Scheibel, Andre S Cavalcanti, Erica N Matos, Luciano J Guimaraes, Flavia P Santos, Licia MH Mota, Eloisa Bonfa and Maria T Terreri in Lupus

Published
2023
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36. Subclinical Pulmonary Hypertension in Childhood Systemic Lupus Erythematosus Associated with Minor Disease Manifestations

Author

Anuardo, Pedro, Verdier, Monica, Gormezano, Natali W. S., Ferreira, Gabriela R. V., Leal, Gabriela N., Lianza, Alessandro, Ferreira, Juliana C. O. A., Pereira, Rosa M. R., Aikawa, Nadia E., Terreri, Maria Teresa, Magalhães, Claudia S., Appenzeller, Simone, dos Santos, Maria Carolina, Sachetti, Silvana B., Len, Claudio A., Pilleggi, Gecilmara S., Lotufo, Simone, Bonfá, Eloisa, and Silva, Clovis A.

Published
2017
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40. Profile of paediatric rheumatology specialists and services in the state of São Paulo

Author

Terreri, Maria Teresa, Campos, Lúcia M.A., Okuda, Eunice M., Silva, Clovis A., Sacchetti, Silvana B., Marini, Roberto, Ferriani, Virginia P., Ventura, Maria Heloiza, Fernandes, Taciana, Sato, Juliana O., Fernandes, Elizabeth C., Len, Claudio, Barbosa, Cássia, Lotito, Ana Paola, dos Santos, Maria Carolina, Aikawa, Nádia E., Facó, Mércia, Piotto, Daniela, Bugni, Vanessa, Kozu, Kátia T., Romanelli, Paulo R., Sallum, Adriana M.E., Febronio, Marília, Fraga, Melissa, and Magalhães, Cláudia S.

Published
2013
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41. Perfil de especialistas e de serviços em reumatologia pediátrica no estado de São Paulo

Author

Teresa Terreri, Maria, Campos, Lúcia M.A., Okuda, Eunice M., Silva, Clovis A., Sacchetti, Silvana B., Marini, Roberto, Ferriani, Virginia P., Heloiza Ventura, Maria, Fernandes, Taciana, Sato, Juliana O., Fernandes, Elizabeth C., Len, Claudio, Barbosa, Cássia, Paola Lotito, Ana, dos Santos, Maria Carolina, Aikawa, Nádia E., Facó, Mércia, Piotto, Daniela, Bugni, Vanessa, Kozu, Kátia T., Romanelli, Paulo R., Sallum, Adriana M.E., Febronio, Marília, Fraga, Melissa, and Magalhães, Cláudia S.

Published
2013
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45. Strong response after fourth dose of mRNA COVID-19 vaccine in autoimmune rheumatic diseases patients with poor response to inactivated vaccine

Author

Aikawa, Nadia E, primary, Kupa, Leonard V K, additional, Silva, Clovis A, additional, Saad, Carla G S, additional, Pasoto, Sandra G, additional, Yuki, Emily F N, additional, Fusco, Solange R G, additional, Shinjo, Samuel K, additional, Andrade, Danieli C O, additional, Sampaio-Barros, Percival D, additional, Pereira, Rosa M R, additional, Chasin, Anna C S, additional, Shimabuco, Andrea Y, additional, Luppino-Assad, Ana P, additional, Leon, Elaine P, additional, Lopes, Marta H, additional, Antonangelo, Leila, additional, Medeiros-Ribeiro, Ana C, additional, and Bonfa, Eloisa, additional

Published
2022
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46. Immunogenicity, safety, and antiphospholipid antibodies after SARS-CoV-2 vaccine in patients with primary antiphospholipid syndrome

Author

Signorelli, Flavio, primary, Balbi, Gustavo Guimarães Moreira, additional, Aikawa, Nadia E, additional, Silva, Clovis A, additional, Kupa, Léonard de Vinci Kanda, additional, Medeiros-Ribeiro, Ana C, additional, Yuki, Emily FN, additional, Pasoto, Sandra G, additional, Saad, Carla GS, additional, Borba, Eduardo F, additional, Seguro, Luciana Parente Costa, additional, Pedrosa, Tatiana, additional, Oliveira, Vitor Antonio de Angeli, additional, Costa, Ana Luisa Cerqueira de Sant’Ana, additional, Ribeiro, Carolina T, additional, Santos, Roseli Eliana Beseggio, additional, Andrade, Danieli Castro Oliveira, additional, and Bonfá, Eloisa, additional

Published
2022
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48. Impact of Distinct Therapies on Antibody Response toSARS‐CoV‐2 Vaccine in Systemic Lupus Erythematosus

Author

Yuki, Emily F. N., primary, Borba, Eduardo F., additional, Pasoto, Sandra G., additional, Seguro, Luciana P., additional, Lopes, Michelle, additional, Saad, Carla G. S., additional, Medeiros‐Ribeiro, Ana Cristina, additional, Silva, Clovis A., additional, Andrade, Danieli C. O., additional, Kupa, Leonard de Vinci K., additional, Betancourt, Lorena, additional, Bertoglio, Isabela, additional, Valim, Juliana, additional, Hoff, Camilla, additional, Formiga, Francisco F. C., additional, Pedrosa, Tatiana, additional, Kallas, Esper G., additional, Aikawa, Nadia E., additional, and Bonfa, Eloisa, additional

Published
2022
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49. Effect of an Exercise Bout Prior to the Booster Dose of an Inactivated SARS-CoV-2 Vaccine on Immunogenicity in Immunocompromised Patients

Author

Gualano, Bruno, primary, Saad, Carla G. S., additional, Sieczkowska, Sofia M., additional, Lemes, Ítalo Ribeiro, additional, Silva, Rafael Pires da, additional, Pinto, Ana J., additional, Mazzolani, Bruna C., additional, Smaira, Fabiana I., additional, Gil, Saulo, additional, Oliveira-Junior, Gersiel, additional, Aikawa, Nadia E., additional, Medeiros-Ribeiro, Ana C., additional, Silva, Clovis A., additional, Yuki, Emily F. N., additional, Pasoto, Sandra G, additional, Pereira, Rosa M.R., additional, Shinjo, Samuel K., additional, Andrade, Danieli C. O., additional, Sampaio-Barros, Percival D., additional, Roschel, Hamilton, additional, and Bonfa, Eloisa, additional

Published
2021
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50. Strong response after fourth dose of mRNA COVID-19 vaccine in autoimmune rheumatic diseases patients with poor response to inactivated vaccine.

Author

Aikawa, Nadia E, Kupa, Leonard V K, Silva, Clovis A, Saad, Carla G S, Pasoto, Sandra G, Yuki, Emily F N, Fusco, Solange R G, Shinjo, Samuel K, Andrade, Danieli C O, Sampaio-Barros, Percival D, Pereira, Rosa M R, Chasin, Anna C S, Shimabuco, Andrea Y, Luppino-Assad, Ana P, Leon, Elaine P, Lopes, Marta H, Antonangelo, Leila, Medeiros-Ribeiro, Ana C, and Bonfa, Eloisa

Subjects
*RITUXIMAB, *HUMAN research subjects, *IMMUNOGLOBULINS, *CONFIDENCE intervals, *COVID-19 vaccines, *MULTIPLE regression analysis, *MULTIVARIATE analysis, *AUTOIMMUNE diseases, *FISHER exact test, *MANN Whitney U Test, *VACCINE effectiveness, *INFORMED consent (Medical law), *T-test (Statistics), *MESSENGER RNA, *DESCRIPTIVE statistics, *RESEARCH funding, *RHEUMATISM, *PREDNISONE, *DATA analysis, *ODDS ratio, *DATA analysis software
Abstract

Objectives To assess immunogenicity of a heterologous fourth dose of an mRNA (BNT162b2) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in autoimmune rheumatic diseases (ARD) patients with poor/non-response to inactivated vaccine (Sinovac-CoronaVac). Methods A total of 164 ARD patients who were coronavirus disease 2019 (COVID-19) poor/non-responders (negative anti-SARS-CoV-2 S1/S2 IgG and/or neutralizing antibodies—NAb) to the third dose of Sinovac-CoronaVac received an additional heterologous dose of mRNA (BNT162b2) 3 months after last dose. IgG and NAb were evaluated before and after the fourth dose. Results Significant increases were observed after the fourth dose in IgG (66.4 vs 95.1%, P  < 0.001), NAb positivity (5.5 vs 83.5%, P  < 0.001) and geometric mean titre (29.5 vs 215.8 AU/ml, P  < 0.001), and 28 (17.1%) remained poor/non-responders. Patients with negative IgG after a fourth dose were more frequently under rituximab (P  = 0.001). Negative NAb was associated with older age (P  = 0.015), RA (P  = 0.002), SSc (P  = 0.026), LEF (P  = 0.016) and rituximab use (P  = 0.007). In multiple logistic regression analysis, prednisone dose ≥7.5 mg/day (OR = 0.34; P  = 0.047), LEF (OR = 0.32, P  = 0.036) and rituximab use (OR = 0.19, P  = 0.022) were independently associated with negative NAb after the fourth vaccine dose. Conclusions This is the largest study to provide evidence of a remarkable humoral response after the fourth dose of heterologous mRNA SARS-CoV-2 vaccination in ARD patients with poor/non-response to the third dose of an inactivated vaccine. We further identified that treatment, particularly rituximab and prednisone, impaired antibody response to this additional dose. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov , CoronavRheum #NCT04754698. [ABSTRACT FROM AUTHOR]

Published
2023
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