Interrupting Immune-Suppresser Treatment Could Boost Effects of COVID-19 Booster

New study findings announced that individuals with inflammatory conditions could improve their antibody response after COVID-19 booster vaccination if they stop treatment with immune suppressors for 2 weeks immediately after receiving the booster shot. Results were found in a large clinical trial that was conducted by researchers at the University of Nottingham, funded by the National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC).

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“COVID-19 has not gone away, and with the emergence of new variants, and vaccine hesitancy among patients, it is important to optimize durable protection in people who are susceptible to COVID-19,” said Professsor Abhishek, Chief Investigator from the University of Nottingham and Honorary Consultant Rheumatologist at Nottingham University Hospitals NHS Trust, in a press release. “Evidence from our trial will help patients and clinicians make informed choices about the risks and benefits of interrupting methotrexate treatment around the time of vaccination against COVID-19.”

The study authors noted that methotrexate is a commonly used immune-suppressing drug. Approximately 1.3 individuals that reside in the UK have been prescribed the medication to treat rheumatoid arthritis and psoriasis. These individuals were defined as high risk throughout the COVID-19 pandemic, among the 2.2 million that were recommended to proceed with caution to avoid infection. However, methotrexate could reduce the body’s ability to produce a response to vaccines—COVID-19 included.

"As winter approaches, millions of people with compromised immune systems are still vulnerable to becoming unwell from COVID-19, despite the disease being less prevalent than it once was,” said Danny McAuley, MD, a professor and Scientific Director for NIHR Programs, in a press release.

The Vaccine Response On Off Methotrexate (VROOM) study included individuals with a collection of inflammatory conditions that could be treated with methotrexate. However, the study authors noted that the interim findings of the VROOM trial were restricted to 250 individuals who were included in a 12-week follow up.

The results found that the antibody response among those that interrupted treatment was doubled at 4 weeks and 1.5 times greater at 26 weeks, compared with individuals that remained on their treatment schedule. The study authors noted that the antibody was reported to remain present for 6 months.

The only reported adverse reactions included inflammatory flare-ups in individuals who interrupted treatment, but study authors noted that it was self-managed. In the full trial results, the researchers found that blood from individuals that stopped taking methotrexate was able at attack the Wuhan strain and the Omicron BA. 1 variant.

The results demonstrated that during the 6-month follow-up, flares were no longer present among individuals that took a break with treatment following the COVID-19 booster immunization.

"This important research provides even more high-quality evidence that by managing medicines in relation to vaccinations we can keep patients healthier while reducing pressure on the NHS,” said McAuley, in a press release.

Reference

Patients can interrupt treatment of immune-supressing medicines for two weeks in order to boost immunity provided by COVID-19 booster vaccine, finds major study. EurekAlert!. News release. December 12, 2023. Accessed December 14, 2023. https://www.eurekalert.org/news-releases/1010786