Graceffa Dario, Sperati Francesca, Bonifati Claudio, Spoletini Gabriele, Lora Viviana, Pimpinelli Fulvia, Pontone Martina, Pellini Raul, Di Bella Ornella, Morrone Aldo, Cristaudo Antonio
Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy.
Front Med (Lausanne). 2022 Sep 6;9:961904. doi: 10.3389/fmed.2022.961904. eCollection 2022.
Psoriasis has not been directly linked to a poor prognosis for COVID-19, yet immunomodulatory agents used for its management may lead to increased vulnerability to the dangerous complications of SARS-CoV-2 infection, as well as impair the effectiveness of the recently introduced vaccines. The three-dose antibody response trend and the safety of BNT162b2 mRNA vaccine in psoriasis patients treated with biologic drugs have remained under-researched.
Forty-five psoriatic patients on biologic treatment were enrolled to evaluate their humoral response to three doses of BNT162b2. IgG titers anti-SARS-CoV-2 spike protein were evaluated at baseline (day 0, first dose), after 3 weeks (second dose), four weeks post-second dose, at the time of the third dose administration and 4 weeks post-third dose. Seropositivity was defined as IgG ≥15 antibody-binding units (BAU)/mL. Data on vaccine safety were also collected by interview at each visit.
A statistically significant increase in antibody titers was observed after each dose of vaccine compared with baseline, with no significant differences between patients and controls. Methotrexate used in combination with biologics has been shown to negatively influence the antibody response to the vaccine. On the contrary, increasing body mass index (BMI) positively influenced the antibody response. No adverse effects were reported, and no relapses of psoriasis were observed in the weeks following vaccine administration in our study population.
Our data are largely consistent with the recent literature on this topic confirming the substantial efficacy and safety of BNT162b2 mRNA vaccine on psoriatic patients treated with biologics of different types and support the recommendation to perform additional doses in this specific subgroup of patients.
银屑病与COVID-19的不良预后没有直接关联，但用于治疗银屑病的免疫调节药物可能会增加感染SARS-CoV-2危险并发症的易感性，还会削弱最近推出的疫苗的效力。三剂次抗体反应趋势以及BNT162b2 mRNA疫苗在接受生物药物治疗的银屑病患者中的安全性仍研究不足。
招募45名接受生物治疗的银屑病患者，以评估他们对三剂BNT162b2的体液反应。在基线（第0天，第一剂）、3周后（第二剂）、第二剂后4周、第三剂给药时以及第三剂后4周评估抗SARS-CoV-2刺突蛋白的IgG滴度。血清阳性定义为IgG≥15抗体结合单位（BAU）/mL。每次就诊时还通过访谈收集疫苗安全性数据。
与基线相比，每次接种疫苗后抗体滴度均有统计学显著升高，患者与对照组之间无显著差异。已证明甲氨蝶呤与生物制剂联合使用会对疫苗的抗体反应产生负面影响。相反，体重指数（BMI）增加对抗体反应有积极影响。在我们的研究人群中，疫苗接种后的几周内未报告不良反应且未观察到银屑病复发。
我们的数据在很大程度上与近期关于该主题的文献一致，证实了BNT162b2 mRNA疫苗对接受不同类型生物制剂治疗的银屑病患者具有显著疗效和安全性，并支持在这一特定亚组患者中接种额外剂次疫苗的建议。
