npj Vaccines (Jan 2024)

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

  • Pedro Martínez-Fleta,
  • Esther F. Vicente-Rabaneda,
  • Ana Triguero-Martínez,
  • Emilia Roy-Vallejo,
  • Miren Uriarte-Ecenarro,
  • Francisco Gutiérrez-Rodríguez,
  • Patricia Quiroga-Colina,
  • Ana Romero-Robles,
  • Nuria Montes,
  • Noelia García-Castañeda,
  • Gina P. Mejía-Abril,
  • Jesús A. García-Vadillo,
  • Irene Llorente-Cubas,
  • José R. Villagrasa,
  • José M. Serra López-Matencio,
  • Julio Ancochea,
  • Ana Urzainqui,
  • Laura Esparcia-Pinedo,
  • Arantzazu Alfranca,
  • Hortensia de la Fuente,
  • Rosario García-Vicuña,
  • Francisco Sánchez-Madrid,
  • Isidoro González-Álvaro,
  • Santos Castañeda

DOI
https://doi.org/10.1038/s41541-024-00805-3
Journal volume & issue
Vol. 9, no. 1
pp. 1 – 9

Abstract

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Abstract 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.