Beneficial effect of temporary methotrexate interruption on B and T cell responses upon SARS-CoV-2 vaccination in patients with rheumatoid arthritis or psoriatic arthritis

• Published in: npj vaccines Vol. 9; no. 1; pp. 21 - 9
• Main Authors: Martínez-Fleta, Pedro, Vicente-Rabaneda, Esther F., Triguero-Martínez, Ana, Roy-Vallejo, Emilia, Uriarte-Ecenarro, Miren, Gutiérrez-Rodríguez, Francisco, Quiroga-Colina, Patricia, Romero-Robles, Ana, Montes, Nuria, García-Castañeda, Noelia, Mejía-Abril, Gina P., García-Vadillo, Jesús A., Llorente-Cubas, Irene, Villagrasa, José R., Serra López-Matencio, José M., Ancochea, Julio, Urzainqui, Ana, Esparcia-Pinedo, Laura, Alfranca, Arantzazu, de la Fuente, Hortensia, García-Vicuña, Rosario, Sánchez-Madrid, Francisco, González-Álvaro, Isidoro, Castañeda, Santos
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 30.01.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250/590/2293; 692/308/575; Antibodies; Antigens; Biomedical and Life Sciences; Biomedicine; COVID-19; COVID-19 vaccines; Cytokines; Drug dosages; Drug withdrawal; Hospitals; Infections; Infectious Diseases; Influenza; Lymphocytes; Medical Microbiology; Medicine; Peptides; Psoriatic arthritis; Public Health; Rheumatoid arthritis; Serology; Severe acute respiratory syndrome coronavirus 2; Vaccine; Virology
• ISSN: 2059-0105; 2059-0105
• DOI: 10.1038/s41541-024-00805-3

B and T cell responses were evaluated in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) after 1 or 2 weeks of methotrexate (MTX) withdrawal following each COVID-19 vaccine dose and compared with those who maintained MTX. Adult RA and PsA patients treated with MTX were recruited and randomly assigned to 3 groups: MTX-maintenance ( n  = 72), MTX-withdrawal for 1 week ( n  = 71) or MTX-withdrawal for 2 weeks ( n  = 73). Specific antibodies to several SARS-CoV-2 antigens and interferon (IFN)-γ and interleukin (IL)-21 responses were assessed. MTX withdrawal in patients without previous COVID-19 was associated with higher levels of anti-RBD IgG and neutralising antibodies, especially in the 2-week withdrawal group and with higher IFN-γ secretion upon stimulation with pools of SARS-CoV-2 S peptides. No increment of RA/PsA relapses was detected across groups. Our data indicate that two-week MTX interruption following COVID-19 vaccination in patients with RA or PsA improves humoral and cellular immune responses.