Fourth dose reduces risk for SARS-CoV-2 for patients with systemic autoimmune rheumatic diseases using DMARDs
By Elana Gotkine HealthDay Reporter
TUESDAY, Nov. 28, 2023 (HealthDay News) — For patients with systemic autoimmune rheumatic diseases using disease-modifying antirheumatic drugs (DMARDs), receiving a fourth COVID-19 mRNA vaccine reduces the risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, according to a study published online Nov. 15 in The Lancet Rheumatology.
Jennifer S. Hanberg, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted an emulated target trial using observational data to compare receiving versus not receiving a fourth mRNA vaccine dose among patients with systemic autoimmune rheumatic diseases who were prescribed DMARDs. Data were included for 4,305 patients: 3,126 received a fourth dose, and 1,179 did not. After emulation of the time-sequential once-per-week trials and overlap propensity score weighting, both groups included 2,563 adults.
Of the 2,563 participants, 54.3 percent had rheumatoid arthritis; the most frequent treatments used were conventional synthetic DMARDs and biological DMARDs (58.1 and 39.3 percent, respectively). The researchers found that the risk for SARS-CoV-2 was lower among patients receiving versus not receiving a fourth vaccine dose (hazard ratio [HR], 0.59). The risk for admission to hospital or death within –3 to +14 days of SARS-CoV-2 infection was also lower with receipt of a fourth vaccine dose (HR, 0.35).
“Patients with systemic autoimmune rheumatic diseases should be encouraged to receive at least four doses of mRNA vaccines,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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