Jean Liew, MD, MS: SARS-COV-2 Infection in Vaccinated Rheumatic Disease Patients


Late-breaking data from ACR 2021 shows that most of the fully vaccinated patients with breakthrough infections of SARS-COV-2 were on anti-metabolites or BCDT.

Breakthrough infections of SARS-COV-2 in fully vaccinated individuals occurred mostly in patients who were on anti-metabolites or B cell-depleting therapies (BCDT), according to late-breaking data presented at the American College of Rheumatology (ACR) 2021 Convergence.

A team of investigators led by Jean Liew, MD, MS, Assistant Professor, Rheumatology, Boston University School of Medicine conducted the study, "SARS-COV-2 Infections Among Vaccinated Individuals with Rheumatic Disease: Results from the COVID-19 Global Rheumatology Alliance Provider Registry".

Investigators examined patients with breakthrough SARS-COV-2 infections who have been vaccinated.

"This is a particular interest in this moment of time as we look towards additional doses of vaccine for people who are immunocompromised, as well as general population," Liew said.

She explained that it's important to monitor patients who are on certain immunomodulatory or immunosuppressive medications and how a SARS-COV-2 infection could impact them.

Laboratory-based studies have shown a reduced antibody response after vaccination for this population. Vaccination offers some protection and is still recommended but patients who are on treatments like rituximab or mycophenolate are at the highest risk of breakthrough infections.

According to Liew, it's imperative to continue to look at other prophylactic strategies pre or post exposure, like monoclonal antibodies or the potential antiviral oral medication.

Patients with rheumatic disease, especially those on immunomodulatory or immunosuppressive medications need to be prioritized and given early access to these treatments.

This research came from the COVID-19 Global Rheumatology Alliance (GRA) registry data, a clinician-entered registry of people with rheumatic disease who have COVID-19.

"I think these data lead the way for studies that focus on some of the questions that remain that other institutions and other groups are looking into," Liew said.

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