Efficacy of corona vaccination in rheumatoid arthritis patients receiving rituximab

Rituximab is a therapeutic antibody used for the treatment of inflammatory rheumatic disorders due to its ability to inhibit B lymphocytes. While B lymphocytes are known to play a role in the pathogenesis of chronic autoimmune disorders via the production of autoantibodies, they are also essential for the production of protective antibodies generated after vaccination.

Rituximab has been in the spotlight recently as it has been shown that it impairs the effectiveness of SARS-CoV-2 vaccination in patients with rheumatic diseases. Ana-Luisa Stefanski and Hector Rincon-Arevalo from Thomas Dörner’s group at the DRFZ, together with colleagues at the Charité – Universitätsmedizin, studied the response to SARS-CoV-2 vaccination in such patients. They found that the number of B cells present in the blood of patients treated with rituximab acts as a biomarker for whether an efficient vaccination response will take place or not. Specifically, if 5% of the normal level of B-cells were still present in the blood, the patients were able to form antibodies against the corona virus and generate virus-specific T-cells after vaccination, albeit to a lesser extent than in healthy individuals. These results may help to optimise the vaccination strategy for patients receiving rituximab treatment to protect them from COVID-19 disease.