Thread by @drdavidliew

Israel was early to COVID vaccinate on mass scale. How well did the vaccine work in their rheum dx pts?

rheum pts n=686 (vs controls n = 121)
- fewer w immunogencity, but not bad (86% vs 100%)
- safety good
- dx activity stable

more details below ⬇️
LB0003 #EULAR2021 @RheumNow

1. Immunogencity 2-6 post-second vaccine dose:
- overall, not bad (86%) but not as good as controls (100%)
- RA/PsA/axSpA/SLE/LVV did well
- IIM/AAV not so well
meds? ritux?⬇️

LB0003 #EULAR2021 @RheumNow
Tel Aviv multicentre, Pfizer vaccine, methods here: ard.bmj.com/content/80/Sup…

2. Somewhat unsurprisingly, rheum meds matter

(to be clear, Ab levels only)
- ritux, but also MMF, abatacept (esp with MTX), and to a lesser extent steroids
- time since ritux made a difference - if not for 1y, then >50%; 1% in first 90d

3/
LB0003 #EULAR2021 @RheumNow

3. So drilling down on those risk factors, age>65y does not help.

*My thoughts:
some pts align for higher risk for both COVID infx and vaccine Ab response
eg we should be
more worried re: older pts on ritux
less worried re: younger pts on TNFi/TCZ

4/
LB0003 #EULAR2021 @RheumNow

4. Ultimately, it was pretty good at working, despite patients and their comorbidities.

(It surely helps that they vaccinated everyone else, quickly)

5/LB0003 #EULAR2021 @RheumNow

5. Safety largely v reassuring in these 686 AI dx pts

3 pts did die though, in months after:
- only 1 from worsened rheum disease (vasculitis flare in stable pt) - causality clearly diff to elucidate!
- other 2 due to pre-existing comorbidities

6/
LB0003 #EULAR2021 @RheumNow

6. Rheum disease activity was stable with COVID vaccination.

(RA, PsA, axSpA, SLE - total n = 597)
7/
LB0003 #EULAR2021 @RheumNow

This is by far the biggest rheum dx COVID vaccinated cohort described I'm aware of 👏

Looking forward to full paper, & we will need data with more pts, more details, cellular response etc.

Nevertheless, invaluable & reassuring.
So glad to see it at #EULAR2021 LB0003 @RheumNow