Post-Covid 19 Vaccination in Ankylosing Spondylitis and Psoriatic Arthritis Patients

Document Type : Original Article

Authors

1 internal medicine, rheumatology department, faculty of medicine, Ain shams university

2 Professor of Internal Medicine and Rheumatology - Ain Shams University Armed Force College of Medicine, Internal Medicine and Rheumatology - Ain Shams University

3 Assistant Professor of Medical Microbiology and Immunology, Military Medical Academy

4 Department of internal medicine and rheumatology military medical academy

5 Lecturer of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University

10.21608/asmj.2025.367369.1407

Abstract

Background: The risk of contracting COVID 19 in patients suffering of ankylosing spondylitis (AS) and psoriatic arthritis
(PsA) diseases has been a focus of ongoing studies. Because of the lack of safety and efficacy data for COVID 19 vaccine in patients with rheumatic diseases and the special interests for the use of immunomodulators , there may be important attitudes differences toward COVID 19 vaccination between systemic rheumatic diseases patients and the general population.
Objective: To study the response of COVID 19 vaccines in patients with ankylosing spondylitis and psoriatic arthritis regarding
effectiveness and side effects.
Subjects and Methods: A case control study including a group of 50 patients with ankylosing spondylitis and psoriatic
arthritis and a group of 50 age and sex matched healthy controls. Type of vaccine and side effects were recorded for all
participants 6 weeks after vaccination. Disease activity was measured using (ASDAS) Ankylosing spondylitis disease activity
score and (DAPSA) Disease Activity in Psoriatic Arthritis Score. Measuring COVID 19 serum IgG antibody was performed
for all participants.
Results: COVID-19 IgG serum levels post vaccination were significantly lower in the group of cases 88.2 mg/dL (78 – 90.1)
than the control group. 93.8 mg/dL (92 – 95), P< 0.0001. There was no significant difference between cases and control
group regarding vaccine side effects (P= 0.16) or response (P= 0.16). COVID-19 IgG antibody levels significantly negatively
correlated with disease duration (P= 0.023), ASDAS score (P<0.0001), DAPSA score (P= 0.0001), CRP (P<0.0015) and ESR
(P<0.0001) .
Conclusion: We found that the side effects of COVID-19 vaccines are similar between AS/PsA patients and healthy population.
However, these patients showed a notably weaker vaccine response, particularly those with higher disease activity and a
longer duration of the disease. The type of vaccine used did not affect the response, nor did the use of IL-17 inhibitors or anti- TNF treatments. Healthcare professionals should recommend COVID-19 vaccination to rheumatic patients, as the benefits of vaccination far outweigh the minimal risk of potential side effects

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