面对 SARS-CoV-2 的持续传播，免疫介导的炎症性疾病 (IMID) 中的 COVID-19 疫苗接种后中和作用的持久性是一个关键问题，药物的效果也是如此。 成人 (n = 112 ）从 2021 年至 2023 年参与的加拿大医疗中心招募了患有炎症性肠病、银屑病/银屑病关节炎、类风湿性关节炎、脊柱关节炎和系统性狼疮的患者。我们重点关注对数转换中和（慢病毒方法）作为连续结果，并具有单独的模型对于野生型和 Omicron 菌株 BA.1 和 BA.5。与接种后 30 至 120 天相比，后续时期与野生型、BA.1 和 BA.5 菌株的未调整模型以及针对调整模型中的 BA.1 应变。在调整后的模型中，利妥昔单抗与 BA.1 菌株的较低中和作用相关，BA.5 的趋势相似。在甲氨蝶呤使用者中，在所有未调整的模型中，BA.1 和 BA.5 的中和都有减少的趋势，而在调整的模型中，仅野生型的中和明显较低。三种或更多剂量和 Omicron 特异性疫苗均与所有三种毒株的更好中和能力独立相关。在调整后的分析中，采样前六个月内的 COVID-19 感染与野生型和 BA.1 的较高中和度相关。在调整分析中，抗肿瘤坏死因子药物与 BA.5 的中和能力较低有关。IMID 免疫抑制个体的中和反应随着时间的推移而持续，并且通过超过三种剂量和 Omicron 特异性疫苗增强。某些药物的中和作用较少。我们的工作阐明了疫苗史、感染和药物对 COVID-19 免疫力的联合影响。© 2024 作者。 ACR Open Rheumatology 由 Wiley periodicals LLC 代表美国风湿病学会出版。

In the face of the ongoing circulation of SARS-CoV-2, the durability of neutralization post-COVID-19 vaccination in immune-mediated inflammatory disease (IMID) is a key issue, as are the effects of medications.Adults (n = 112) with inflammatory bowel disease, psoriasis/psoriatic arthritis, rheumatoid arthritis, spondylarthritis, and systemic lupus were recruited from participating Canadian medical centers from 2021 to 2023. We focused on log-transformed neutralization (lentivirus methods) as a continuous outcome, with separate models for wild-type and Omicron strains BA.1 and BA.5.Compared with 30 to 120 days postvaccination, subsequent periods were associated with greater neutralization in unadjusted models for wild-type, BA.1, and BA.5 strains and against the BA.1 strain in adjusted models. Rituximab was associated with lower neutralization for the BA.1 strain in adjusted models, with a similar trend for BA.5. In methotrexate users, there were trends for less neutralization of BA.1 and BA.5 in all unadjusted models, whereas in adjusted models, there was significantly lower neutralization only for the wild type. Three or more doses and Omicron-specific vaccines were both independently associated with better neutralization ability for all three strains. A COVID-19 infection within six months before sampling was associated with higher neutralization of wild type and BA.1 in adjusted analyses. Anti-tumor necrosis factor agents were associated with lower neutralization ability for BA.5 in adjusted analyses.Neutralization responses in immunosuppressed individuals with IMID were durable over time and were augmented by more than three doses and Omicron-specific vaccines. Less neutralization was seen with certain medications. Our work clarifies the joint effects of vaccine history, infection, and medications on COVID-19 immunity.© 2024 The Author(s). ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.