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    Oral Communication

    COVID

    Vaccination Against COVID-19 and Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT)

    OC 76.4 - Elevation of antiphospholipid antibody titers following vaccination with SARS-CoV-2 mRNA in patients with antiphospholipid syndrome and/or systemic lupus erythematosus

    Wednesday, June 28, 2023
    11:00 – 11:15 ET
    Room: 524
    Session Available As: On-Demand

      Presenting Author(s)

    • Mitsutaka Yasuda, MD (he/him/his)

      Senior Resident
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

      • Co-Author(s)

    • YF

      Yuichiro Fujieda

      Assistant Professor
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • KS

      Kodai Sakiyama

      Senior Resident
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • MT

      Maria Tada

      Senior Resident
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • HM

      Haruka Moriya

      Senior Resident
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • JW

      Jiang Wei

      Graduate Student Researcher
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • RH

      Ryo Hisada

      Assistant Professor
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • MK

      Michihito Kono

      Assistant Professor
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • MK

      Masaru Kato

      Lecturer
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • OA

      Olga Amengual

      Lecturer
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    • AY

      Atsushi Yasumoto

      Assistant Professor
      Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
      Sapporo, Hokkaido, Japan

    • Eriko Morishita, MD, PhD

      Professor
      Department of Clinical Laboratory Science, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University
      Kanazawa, Ishikawa, Japan

    • Tetsumei Urano, MD, PhD (he/him/his)

      Emeritus Professor, Special Research Professor
      Department of Medical Physiology, Hamamatsu University School of Medicine
      Hamamatsu, Shizuoka, Japan

    • TA

      Tatsuya Atsumi

      Professor
      Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
      Sapporo, Hokkaido, Japan

    Background: COVID-19 is characterized by a hypercoagulable state and antiphospholipid antibodies (aPLs) are detected in some cases.

    Aims: We aimed to evaluate the change of aPL titers and the risk of thrombosis following mRNA vaccination against COVID-19 in patients with antiphospholipid syndrome (APS), systemic lupus erythematosus (SLE) and healthy controls (HC).

    Methods: This study comprised primary APS (PAPS), APS associated with SLE (SLE/APS), SLE with positive criteria aPL (SLE/aPL+), SLE without criteria aPL (SLE/aPL-), and HC who received the second dose of SARS-CoV-2 mRNA vaccine. Blood was collected pre- and post-vaccination from the patients and only post-vaccination from HC. Serum anti-cardiolipin antibodies (aCL IgG/IgM) and anti-β2GPI antibodies (aβ2GPI IgG/IgM) were detected by chemiluminescent immunoassay (CLIA), and anti-phosphatidylserine/prothrombin complex antibodies (aPS/PT IgG/IgM) were tested using an in-house enzyme-linked immunosorbent assay (ELISA). “Criteria aPL” was defined according to the 2006 APS classification criteria. “Notable increase” of aPL titers was defined more than 50% after vaccination. We observed patients for three months after the second vaccination.

    Results: A total of 118 patients; 79 aPL-positive (19 PAPS, 25 SLE/APS, 35 SLE/aPL+) and 39 aPL-negative (SLE/aPL-), and 884 HC were enrolled. The rate of newly positive aβ2GPI IgG and aPS/PT IgG/IgM were significantly different among the groups (aPL+ vs aPL- vs HC: aβ2GPI IgG 8.9% vs 7.7% vs 0.8%, p< 0.001; aPS/PT IgG 12.7% vs. 0 %vs 0. 1%, p< 0.001; aPS/PT IgM 7.6% vs. 0% vs 0%, p< 0.001). The sub-analysis of the patient group revealed that the rate of “notable increase” of aPS/PT IgG in aPL+ group (13.9%) was significantly higher than that in aPL- group (2.6%) (p=0.047). No thrombotic events were detected during the observation period.

    Conclusion(s): aβ2GPI IgG and aPS/PT IgG/IgM, representing high thrombotic risks in APS and/or SLE, elevated after vaccination in some aPL positive patients.

    Learning Objectives:

    • describe precise information from the results of their study to the audience
    • differentiate between subjective and objective needs assessment and describe the importance of both
    • acquire the skills to conduct scientific discussion in their non-native language