Importance of the second SARS-CoV-2 vaccination dose for achieving serological response in patients with rheumatoid arthritis and seronegative spondyloarthritis

ObjectivesTo assess the kinetics of humoral response after the first and second dose of messenger RNA (mRNA) vaccines in patients with inflammatory joint diseases compared with healthy controls (HC). To analyse factors influencing the quantity of the immune response.MethodsWe enrolled patients with rheumatoid arthritis (RA) and seronegative spondyloarthritis (SpA), excluding those receiving B-cell depleting therapies and assessed the humoral response to mRNA vaccines after the first and the second dose of the vaccine in terms of seroconversion rate and titre. We compared the results to a HC group and analysed the influence of therapies as well as other characteristics on the humoral response.ResultsSamples from 53 patients with RA, 46 patients with SpA and 169 healthy participants were analysed. Seroconversion rates after the first immunisation were only 54% in patients with inflammatory arthritis compared with 98% in the HC group. However, seroconversion rates were 100% in all groups after second immunisation. Patients developed reduced antibody titres after the first vaccination compared with HC, but there was no difference after the second dose. While disease modifying anti-rheumatic drug (DMARD) monotherapy did not affect antibody levels, seroconversion rates as well as titre levels were reduced in patients receiving a combination of DMARDs compared with HC.ConclusionsPatients with inflammatory joint diseases under DMARD therapy show impaired humoral responses to the first vaccine dose but excellent final responses to vaccination with mRNA vaccines. Therefore, the full course of two immunisations is necessary for efficient vaccination responses in patients with inflammatory arthritis under DMARD therapy.

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Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with B-cell non-Hodgkin lymphoma

Blood Advances ◽

10.1182/bloodadvances.2021005094 ◽

2021 ◽

Vol 5 (16) ◽

pp. 3053-3061

Author(s):

C. Perry ◽

E. Luttwak ◽

R. Balaban ◽

G. Shefer ◽

M. M. Morales ◽

...

Keyword(s):

B Cell ◽

Hodgkin Lymphoma ◽

Messenger Rna ◽

Vaccine Dose ◽

Humoral Response ◽

Response Rates ◽

Serological Response ◽

Healthy Controls ◽

Non Hodgkin Lymphoma ◽

Anti Cd20

Abstract Patients diagnosed with B-cell non-Hodgkin lymphoma (B-NHL), particularly if recently treated with anti-CD20 antibodies, are at risk of severe COVID-19 disease. Because studies evaluating humoral response to COVID-19 vaccine in these patients are lacking, recommendations regarding vaccination strategy remain unclear. The humoral immune response to BNT162b2 messenger RNA (mRNA) COVID-19 vaccine was evaluated in patients with B-NHL who received 2 vaccine doses 21 days apart and compared with the response in healthy controls. Antibody titer, measured by the Elecsys Anti-SARS-CoV-2S assay, was evaluated 2 to 3 weeks after the second vaccine dose. Patients with B-NHL (n = 149), aggressive B-NHL (a-B-NHL; 47%), or indolent B-NHL (i-B-NHL; 53%) were evaluated. Twenty-eight (19%) were treatment naïve, 37% were actively treated with a rituximab/obinutuzumab (R/Obi)–based induction regimen or R/Obi maintenance, and 44% had last been treated with R/Obi >6 months before vaccination. A seropositive response was achieved in 89%, 7.3%, and 66.7%, respectively, with response rates of 49% in patients with B-NHL vs 98.5% in 65 healthy controls (P < .001). Multivariate analysis revealed that longer time since exposure to R/Obi and absolute lymphocyte count ≥0.9 × 103/μL predicted a positive serological response. Median time to achieve positive serology among anti-CD20 antibody-treated patients was longer in i-B-NHL vs a-B-NHL. The humoral response to BNT162b2 mRNA COVID-19 vaccine is impaired in patients with B-NHL who are undergoing R/Obi treatment. Longer time since exposure to R/Obi is associated with improved response rates to the COVID-19 vaccine. This study is registered at www.clinicaltrials.gov as #NCT04746092.

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Mechanisms and Mediators of Pain in Chronic Inflammatory Arthritis

Current Treatment Options in Rheumatology ◽

10.1007/s40674-021-00178-x ◽

2021 ◽

Author(s):

Marco Di Carlo ◽

Gianluca Smerilli ◽

Fausto Salaffi

Keyword(s):

Inflammatory Pain ◽

Inflammatory Arthritis ◽

Operational Definition ◽

Immunosuppressive Drugs ◽

Therapeutic Strategies ◽

Future Research ◽

Common Symptom ◽

Joint Diseases ◽

Chronic Inflammatory Arthritis ◽

Inflammatory Joint Diseases

Abstract Purpose of the review Pain in chronic inflammatory joint diseases is a common symptom reported by patients. Pain becomes of absolute clinical relevance especially when it becomes chronic, i.e., when it persists beyond normal healing times. As an operational definition, pain is defined chronic when it lasts for more than 3 months. This article aims to provide a review of the main mechanisms underlying pain in patients with chronic inflammatory joint diseases, discussing in particular their overlap. Recent findings While it may be intuitive how synovial inflammation or enthesitis are responsible for nociceptive pain, in clinical practice, it is common to find patients who continue to complain of symptoms despite optimal control of inflammation. In this kind of patients at the genesis of pain, there may be neuropathic or nociplastic mechanisms. Summary In the context of chronic inflammatory joint diseases, multiple mechanisms generally coexist behind chronic pain. It is the rheumatologist’s task to identify the mechanisms of pain that go beyond the nociceptive mechanisms, to adopt appropriate therapeutic strategies, including avoiding overtreatment of patients with immunosuppressive drugs. In this sense, future research will have to be oriented to search for biomarkers of non-inflammatory pain in patients with chronic inflammatory joint diseases.

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Oligonucleotide Therapies in the Treatment of Arthritis: A Narrative Review

Biomedicines ◽

10.3390/biomedicines9080902 ◽

2021 ◽

Vol 9 (8) ◽

pp. 902

Author(s):

Susanne N. Wijesinghe ◽

Mark A. Lindsay ◽

Simon W. Jones

Keyword(s):

Rheumatoid Arthritis ◽

Articular Cartilage ◽

Joint Diseases ◽

Synovial Joint ◽

Pharmacological Treatments ◽

In Vivo Models ◽

Inflammatory Joint Diseases ◽

Joint Pathology ◽

Cellular Pathways

Osteoarthritis (OA) and rheumatoid arthritis (RA) are two of the most common chronic inflammatory joint diseases, for which there remains a great clinical need to develop safer and more efficacious pharmacological treatments. The pathology of both OA and RA involves multiple tissues within the joint, including the synovial joint lining and the bone, as well as the articular cartilage in OA. In this review, we discuss the potential for the development of oligonucleotide therapies for these disorders by examining the evidence that oligonucleotides can modulate the key cellular pathways that drive the pathology of the inflammatory diseased joint pathology, as well as evidence in preclinical in vivo models that oligonucleotides can modify disease progression.

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Rheumatoid arthritis and other inflammatory joint diseases (animal models) (WS-037)

International Immunology ◽

10.1093/intimm/dxq300 ◽

2010 ◽

Vol 22 (Suppl_1_Pt_2) ◽

pp. ii104-ii105

Keyword(s):

Rheumatoid Arthritis ◽

Animal Models ◽

Joint Diseases ◽

Inflammatory Joint Diseases

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Synovial fluid proteomic fingerprint: S100A8, S100A9 and S100A12 proteins discriminate rheumatoid arthritis from other inflammatory joint diseases

Rheumatology ◽

10.1093/rheumatology/kep452 ◽

2010 ◽

Vol 49 (4) ◽

pp. 671-682 ◽

Cited By ~ 73

Author(s):

A. Baillet ◽

C. Trocme ◽

S. Berthier ◽

M. Arlotto ◽

L. Grange ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Synovial Fluid ◽

Joint Diseases ◽

Inflammatory Joint Diseases

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Efficacy of the BNT162b2 mRNA COVID-19 Vaccine in Patients with Chronic Lymphocytic Leukemia: A Serologic and Cellular Study

Chemotherapy ◽

10.1159/000521229 ◽

2021 ◽

Author(s):

Stefano Molica ◽

Diana Giannarelli ◽

Mirella Lentini ◽

Daniela Zappala ◽

Ada Mannella ◽

...

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Antibody Response ◽

Messenger Rna ◽

Vaccine Dose ◽

Lymphocytic Leukemia ◽

Serological Response ◽

Humoral Immune ◽

Treatment Naïve ◽

Cd20 Antibody ◽

Anti Cd20

Background: Antibody response following SARS-CoV2 vaccination is somewhat defective in chronic lymphocytic leukemia (CLL). Moreover, the correlation between serologic response and status of cellular immunity has been poorly studied. Objective: This study was undertaken to assess humoral immune and cellular responses to the BNT162b2 messenger RNA (mRNA) COVID-19 vaccination in CLL. Methods: The presence of the spike antibodies was assessed at a median time of 14 days from the second vaccine dose of SARS-CoV2 in 70 CLL followed-up at a single institution. Results: The antibody response rate (RR) in CLL patients was 58.5%, compared to 100% of 57 healthy controls of the same sex and age (P< 0.0001). Patients treatment-naïve and those in sustained clinical remission after therapy had the highest RR (87.0% and 87.7%, respectively). In contrast, patients on therapy with a pathway inhibitor as monotherapy and those treated with an association of anti-CD20 antibody were unlikely to respond to the SARS-CoV-2 vaccine (52% and 10%, respectively). In multivariate analysis, early Rai stage (OR, 0.19 [0.05-0.79]; P=0.02) and no previous therapy (OR, 0.06[0.02-0.27]; P<0.0001) were found to be independent predictors of vaccination response. An increase in absolute NK cells (i.e., CD16/CD56 positive cells) in patients with a serological response was found following the second dose of vaccine (P=0.02). Conclusions: These results confirm that serological response to the BNT162b2 vaccine in patients with CLL is impaired. A third boosting vaccine dosage should be considered for these patients.

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Osteoarthritis, osteoarthrosis and osteoarthropathy: What is the difference?

Srpski medicinski casopis Lekarske komore ◽

10.5937/smclk2101015j ◽

2021 ◽

Vol 2 (1) ◽

pp. 25-32

Author(s):

Danilo Jeremić ◽

Boris Gluščević ◽

Stanislav Rajković ◽

Želimir Jovanović ◽

Branislav Krivokapić

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Presentation ◽

Joint Disease ◽

Joint Diseases ◽

Significant Progress ◽

Inflammatory Joint Diseases ◽

The Past ◽

Inflammatory Arthropathy ◽

The Difference ◽

Made In

Osteoarthritis, osteoarthrosis, and osteoarthropathy are diseases that doctors encounter daily in their practice. The use of all three terms is customary, often without a clear justification as to why a particular term is used for a particular case. In the past several decades, doctors mainly differentiated among these diseases based on clinical presentation and radiography. In the past several years, however, significant progress has been made in the field of biochemical, immunological, and cytohistological research, which has provided explanations for the pathogenesis of these conditions, enabled defining differences amongst them and facilitated the use of appropriate terms for each one of these diseases. The term arthritis (osteoarthritis) should be used exclusively for primarily inflammatory joint diseases-rheumatoid arthritis, juvenile arthritis, reactive arthritis (Reiter's syndrome). If the etiology is infectious, this must also be emphasized-septic (purulent) arthritis, tuberculous arthritis. Arthrosis (osteoarthrosis) relates to changes in the joints occurring due to pathological processes within the joint itself, but which, in their basis, are not inflammatory. Arthropathy is a term for joint disease stemming from another diseased organ or system of organs.

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