TY - JOUR
T1 - The COVID-19 pandemic and ANCA-associated vasculitis – reports from the EUVAS meeting and EUVAS education forum
AU - Kronbichler, Andreas
AU - Geetha, Duvuru
AU - Smith, Rona M.
AU - Egan, Allyson C.
AU - Bajema, Ingeborg M.
AU - Schönermarck, Ulf
AU - Mahr, Alfred
AU - Anders, Hans Joachim
AU - Bruchfeld, Annette
AU - Cid, Maria C.
AU - Jayne, David R.W.
N1 - Funding Information:
EUVAS receives funding from Vifor Fresenius Medical Care Renal Pharma Ltd., Hoffman La Roche, InflaRx and the charity Vasculitis UK. HJA was supported by the Deutsche Forschungsgemeinschaft ( AN372/30-1 ). The funding bodies had no influence over the conduct of the study.
Funding Information:
EUVAS receives funding from Vifor Fresenius Medical Care Renal Pharma Ltd., Hoffman La Roche, InflaRx and the charity Vasculitis UK. HJA was supported by the Deutsche Forschungsgemeinschaft (AN372/30-1). The funding bodies had no influence over the conduct of the study.AK has served as a consultant for Alexion, Otsuka, and Vifor Pharma, and has received grant/research support from Vifor Pharma, and Terumo BCT. DG served as a consultant for ChemoCentryx and Aurinia. RMS, ACE, and IMB have no competing interests. US has received consulting fees from Ablynx, Alexion and Vifor Pharma and reports research support from Vifor Pharma, Ablynx/Sanofi and Alexion. AM reports consulting/meeting fees from Celgene and speaking fees from Roche/Chugai. HJA reports personal fees from Janssen, GSK, Bayer, Boehringer Ingelheim, AstraZeneca, Novartis, Kezar and Previpharma. AB reports personal fees from AstraZeneca, ChemoCentryx, Merck/MSD, Vifor and Abbvie. MCC has no competing interests. DRWJ has received consulting or lecture fees or research grants from AstraZeneca, ChemoCentryx, Chugai, GSK, InflaRx, Insmed, Roche/Genentech, Sanofi/Genzyme, Takeda and VielaBio.
Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/12
Y1 - 2021/12
N2 - The Coronavirus Disease 2019 (COVID-19) pandemic influenced the management of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. A paucity of data exists on outcome of patients with vasculitis following COVID-19, but mortality is higher than in the general population and comparable to patients undergoing haemodialysis or kidney transplant recipients (reported mortality rates of 20–25%). Delays in diagnosis have been reported, which are associated with sequelae such as dialysis-dependency. Management of ANCA-associated vasculitis has not changed with the aim to suppress disease activity and reduce burden of disease. The use of rituximab, an important and widely used agent, is associated with a more severe hospital course of COVID-19 and absence of antibodies following severe acute respiratory syndrome (SARS)-CoV-2 infections, which prone patients to re-infection. Reports on vaccine antibody response are scarce at the moment, but preliminary findings point towards an impaired immune response, especially when patients receive rituximab as part of their treatment. Seropositivity was reported in less than 20% of patients when rituximab was administered within the prior six months, and the antibody response correlated with CD19+ B-cell repopulation. A delay in maintenance doses, if disease activity allows, has been suggested using a CD19+ B-cell guided strategy. Other immunosuppressive measures, which are used in ANCA-associated vasculitis, also impair humoral and cellular vaccine responses. Regular measurements of vaccine response or a healthcare-policy time-based strategy are indicated to provide additional doses (“booster”) of COVID-19 vaccines. This review summarizes a recent educational forum and a recent virtual meeting of the European Vasculitis Society (EUVAS) focusing on COVID-19.
AB - The Coronavirus Disease 2019 (COVID-19) pandemic influenced the management of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. A paucity of data exists on outcome of patients with vasculitis following COVID-19, but mortality is higher than in the general population and comparable to patients undergoing haemodialysis or kidney transplant recipients (reported mortality rates of 20–25%). Delays in diagnosis have been reported, which are associated with sequelae such as dialysis-dependency. Management of ANCA-associated vasculitis has not changed with the aim to suppress disease activity and reduce burden of disease. The use of rituximab, an important and widely used agent, is associated with a more severe hospital course of COVID-19 and absence of antibodies following severe acute respiratory syndrome (SARS)-CoV-2 infections, which prone patients to re-infection. Reports on vaccine antibody response are scarce at the moment, but preliminary findings point towards an impaired immune response, especially when patients receive rituximab as part of their treatment. Seropositivity was reported in less than 20% of patients when rituximab was administered within the prior six months, and the antibody response correlated with CD19+ B-cell repopulation. A delay in maintenance doses, if disease activity allows, has been suggested using a CD19+ B-cell guided strategy. Other immunosuppressive measures, which are used in ANCA-associated vasculitis, also impair humoral and cellular vaccine responses. Regular measurements of vaccine response or a healthcare-policy time-based strategy are indicated to provide additional doses (“booster”) of COVID-19 vaccines. This review summarizes a recent educational forum and a recent virtual meeting of the European Vasculitis Society (EUVAS) focusing on COVID-19.
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U2 - 10.1016/j.autrev.2021.102986
DO - 10.1016/j.autrev.2021.102986
M3 - Review article
C2 - 34718165
AN - SCOPUS:85118337082
SN - 1568-9972
VL - 20
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
IS - 12
M1 - 102986
ER -