Correspondence on 'Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort'.

TLDR: In this paper, the authors investigated the immune response to SARS-CoV-2 vaccination in patients with AIDs and found no improvement of COVID-19 on IL-1 blockade.

Abstract: We read with interest the work by Geisen and colleagues1 on the efficacy and safety of anti-SARS-CoV-2 mRNA vaccine in patients with rheumatic diseases. While substantial data on the efficacy and safety of SARS-CoV-2 vaccination have been created during the last months, it is currently unclear whether the vaccination is efficacious and safe in patients with autoinflammatory diseases (AIDs). These patients present with exacerbated innate immune responses associated with enhanced production of interleukin (IL)-1.2 Testing the immune response to SARS-CoV-2 vaccination in patients with AIDs is of interest, as IL-1 has been involved in the pathogenesis of COVID-19; thus, IL-1 expression is massively increased in patients with severe COVID-19.3–5 Furthermore, COVID-19 has shown to trigger an increased inflammatory disease activity in patients with AIDs.6 7 In addition, IL-1 inhibition has been applied in the treatment of COVID-19 and while initial uncontrolled studies revealed promising results,8 a randomised controlled trial showed no improvement of COVID-19 on IL-1 blockade.9 While current data suggest the immune response to SARS-CoV-2 vaccination may be reduced in certain diseases, such as rheumatoid arthritis,10 and certain treatments such as methotrexate,11 such data cannot be applied to AID or to IL-1 inhibitors as the underlying pathophysiology is fundamentally different. Hence, we aimed to investigate SARS-CoV-2 vaccination …