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COVID vaccine effective with rituximab

Wednesday August 4th 2021

COVID-19 vaccination can effectively produce antibodies in patients on rituximab treatment, according to a new European study.

There has been concern over the effectiveness of vaccination while a patient with inflammatory disease is taking immune modulating therapy. One of the most widely used of these treatments is rituximab, a monoclonal antibody which suppresses the immune system, specifically depleting B cells.

These patients are at risk for more severe COVID-19 infection, and rituximab treatment in particular might affect the course of the disease.

Now, Dr Michael Bonelli, of the Medical University of Vienna, Austria, and colleagues have investigated whether B cells are needed for antibody development in patients on rituximab.

They assessed the relation between the immune response to COVID-19 vaccination and numbers of peripheral B cells.

The study showed that an immune response after vaccination, mediated by T cells, "was detected in the majority of patients after rituximab treatment irrespective of the presence or absence of B cells and a humoral immune response", they report.

The team concludes: "Rituximab treatment should not preclude COVID-19 vaccination, since a robust T-cell response can be mounted even in the absence of circulating B cells.

"Delaying rituximab treatment may be justified in patients with stable disease until peripheral B cells repopulate to allow development of a humoral response to vaccination."

Details appeared yesterday in the BMJ journal Annals of the Rheumatic Diseases.

Dr Bonelli commented: "B cells constitute an important cell population for the development of antibodies. We were able to show that more than 50% of patients receiving B-cell-depleting treatment with rituximab still develop antibodies to SARS-CoV-2 and that there is potentially additional protection via a cellular immune response.

"This underscores the importance of vaccinating immunosuppressed patients against SARS-CoV-2."

Mrak, D. et al. SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity. Annals of the Rheumatic Diseases 3 August 2021; doi: 10.1136/annrheumdis-2021-220781

[abstract]

Tags: Europe | Flu & Viruses | Pharmaceuticals | Rheumatology

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