Is inflammation medicine harmful

Get vaccinated against COVID-19 with Crohn's disease or rheumatism?

Autoimmune diseases such as rheumatism, psoriasis or chronic inflammatory bowel disease are often treated with immunosuppressive drugs. However, the question of to what extent a COVID-19 vaccination is effective and safe for the affected patients has not yet been answered, as people with immunosuppressive therapy were excluded in the approval studies of the new mRNA vaccines. Researchers from the Cluster of Excellence “Precision Medicine in Chronic Inflammation” (PMI) have now investigated this question in a small study. The results published in the journal “Annals of the Rheumatic Diseases” show that the new mRNA vaccines against COVID-19 are effective and well tolerated in people with chronic inflammatory diseases and immunosuppressive therapy.

Worrying about new flare-ups is unfounded

“For many patients with chronic inflammatory diseases and a corresponding immunosuppressive therapy, there was great concern that the vaccination would either not work adequately due to the suppressed immune system or that it could lead to new inflammatory attacks,” explains lead author Bimba Hoyer, professor of rheumatology of the Christian-Albrechts-Universität zu Kiel (CAU) and head of the Center of Excellence for Inflammatory Medicine at the University Medical Center Schleswig-Holstein (UKSH), Campus Kiel. “We know from the influenza vaccination that it is also effective in people with immunosuppressive therapies and is well tolerated by them. But for many other vaccines, there is little data on the efficacy and safety of this particular group of people. In addition, the new mRNA vaccines use a completely new, previously unused mechanism of action, so there was an urgent need for research, ”continues Hoyer.

Study with 25 patients plus control group

For the study, the Kiel researchers examined 25 patients with various chronic inflammatory diseases at different times after vaccination with an mRNA COVID-19 vaccine and compared the reactions with those of healthy vaccinated people. All study participants were medically well adjusted with immunosuppressive therapy, that is, they had little or no disease activity at the time of vaccination. The vaccination itself was not part of the study, all participants belonged to priority group 1 and were therefore vaccinated at the beginning of the vaccinations in Schleswig-Holstein.

No fever occurred after vaccination

"In our study, vaccination with one of the mRNA vaccines did not lead to any disease activity in the patients, we could neither molecularly nor clinically detect any inflammation that flared up again," reports Dr. Ulf Geisen, first author of the study and scientist in the Rheumatology Department of the Clinic for Internal Medicine I at the UKSH, Campus Kiel. In the group with chronic inflammatory diseases, neither different nor more frequent side effects occurred than in the comparison group or in the approval studies. In fact, none of this group developed a fever, while some of the healthy participants experienced this side effect.

Age-appropriate vaccination response

According to the current state of knowledge, all persons with immunosuppressive therapy also showed an adequate vaccination response to the vaccines. However, the measured antibody levels, which serve as markers for vaccination success, were lower in a few patients than in the control group. “This is possibly due to the older age of these patients. Even in healthy elderly people, the antibody levels are usually lower after a vaccination, ”explains Hoyer. “The lower antibody level could have an impact on how long the vaccination lasts. We want to investigate this in future studies. The group of people with immunosuppressive therapy may have to have their vaccinations refreshed earlier than in healthy people, ”says Hoyer.

No difference can be seen between the individual atoimmune disorders

The study mainly included patients with rheumatoid arthritis, but also vaccinated people with other rheumatic diseases, with the chronic skin disease psoriasis (psoriasis) or with chronic inflammatory bowel diseases such as Crohn's disease. “The symptoms of these diseases differ significantly from one another, as they affect very different areas of the body such as joints, skin or the intestines. At the same time, the underlying disease mechanisms are astonishingly similar, as we have been able to show in numerous studies. This is why the drug groups used in these various diseases also overlap, ”explains co-author and cluster spokesman Professor Stefan Schreiber. “That is why we examined patients with various of these diseases in this study, but some of them were receiving the same immunosuppressive therapies. So far we have not been able to see any differences in the effectiveness or tolerability of the vaccinations between the various diseases and therapies examined. "

Photo: © Adobe Stock / Framestock

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