Impact of Low-Dose Methotrexate-Adalimumab Combination Therapy on the Antibody Response Induced by the mRNA-1273 SARS-CoV-2 Vaccine: Case of an Elderly Patient with Rheumatoid Arthritis

Yves Michiels; Nadhira Houhou-Fidouh; Gilles Collin; Jérôme Berger; Evelyne Kohli

doi:10.3390/vaccines9080883

Impact of Low-Dose Methotrexate-Adalimumab Combination Therapy on the Antibody Response Induced by the mRNA-1273 SARS-CoV-2 Vaccine: Case of an Elderly Patient with Rheumatoid Arthritis

Vaccines (Basel). 2021 Aug 9;9(8):883. doi: 10.3390/vaccines9080883.

Authors

Yves Michiels^{1

2}, Nadhira Houhou-Fidouh³, Gilles Collin³, Jérôme Berger^{1

4

5}, Evelyne Kohli^{6

7

8}

Affiliations

¹ Community Pharmacy, Center for Primary Care and Public Health (Unisanté) Lausanne 1011, University of Lausanne, 1015 Lausanne, Switzerland.
² Pharmacie Michiels, 21600 Longvic, France.
³ Laboratoire de Virologie, Hôpital Bichat, Sorbonne Paris Cité, Université Paris Diderot, AP-HP, 75018 Paris, France.
⁴ School of Pharmaceutical Sciences, University of Geneva, 1205 Geneva, Switzerland.
⁵ Institute of Pharmaceutical Sciences of Western Switzerland, University of Lausanne, 1015 Lausanne, Switzerland.
⁶ UMR INSERM/uB/AGROSUP 1231, Team 3 HSP-Pathies, Labellisée Ligue Nationale Contre le Cancer and Laboratoire d'Excellence LipSTIC, 21000 Dijon, France.
⁷ UFR des Sciences de Santé, Université de Bourgogne, 21000 Dijon, France.
⁸ CHU, 2100 Dijon, France.

Abstract

Patients with rheumatoid arthritis (RA) are treated with drugs that may impact their immune responses to SARS-CoV-2 vaccines. We describe here the anti-Spike (anti-S) IgG and neutralizing antibody responses induced by the mRNA-1273 SARS-CoV-2 vaccine in a 78-years-old patient with RA, who received a low-dose combination therapy of methotrexate and adalimumab, shortly before vaccine administration. Both near-normal and impaired immune responses to vaccines have been reported previously in patients treated with these drugs. Our case report shows that, even at low doses, combined methotrexate-adalimumab therapy can be associated with a weak immune response to the mRNA1273 vaccine in elderly patients.

Keywords: SARS-CoV-2; adalimumab; antibody response; mRNA1273 vaccine; methotrexate.

Publication types

Case Reports