Immunogenicity, Safety, and Clinical Outcomes Following Homologous and Heterologous SARS-CoV-2 Vaccination Regimens in Patients with Axial Spondyloarthritis and Psoriatic Arthritis: A Prospective Observational Study from the SAFER Cohort.

@article{magalhaes2026immunogenicity,
  title = {{Immunogenicity, Safety, and Clinical Outcomes Following Homologous and Heterologous SARS-CoV-2 Vaccination Regimens in Patients with Axial Spondyloarthritis and Psoriatic Arthritis: A Prospective Observational Study from the SAFER Cohort.}},
  author = {Vanessa de Oliveira Magalhães and Priscila Dias Cardoso Ribeiro and Flávia Maria Matos Melo Campos Peixoto and Erika Biegelmeyer and Mariana Freitas de Aguiar and Cristiane Kayser and Alexandre Wagner Silva de Souza and Charlles Heldan de Moura Castro and Ketty Lysie Libardi Lira Machado and José Geraldo Mill and Nésio Fernandes de Medeiros Junior and Danielle Cristina Filgueira Alves Batista and Rebeca Silva Moreira da Fraga and Thaisa de Moraes Ribeiro Espirito Santo and Samira Tatiyama Miyamoto and Gabriel Smith Sobral Vieira and Pietra Zava Lorencini and Bárbara Oliveira Souza and Heitor Filipe Surlo and Anna Carolina Simões Moulin and Paula Dos Santos Athayde and Mariana de Oliveira Macabú and Sandra Lúcia Euzébio Ribeiro and Raquel Lima de Lima and Natália Seixas de Melo and Russian Teixeira Rebello and Marcos Mavignier Sousa Dias and Jonathan Willian da Silva Rodrigues and Camila Maria Paiva França Telles and Natália Sarzi Sartori and Regiane Lima and Rodrigo Poubel Vieira de Rezende and Katia Lino Baptista and Rodrigo Cutrim Gaudio and Ana Karla Guedes de Melo and Valéria Bezerra da Silva and Vitor Alves Cruz and Jozelia Rêgo and Rejane Maria Rodrigues de Abreu Vieira and Adah Sophia Rodrigues Vieira and Adriana Maria Kakehasi and Anna Carolina Faria Moreira Gomes Tavares and Artur José Azevedo Pereira and Renata Henriques de Azevedo and Valderilio Feijó Azevedo and Olindo Assis Martins-Filho and Vanessa Peruhype-Magalhães and Emilia Inoue Sato and Ricardo Machado Xavier and Andréa Teixeira-Carvalho and Viviane Angelina de Souza and Gilda Aparecida Ferreira and Edgard Torres Dos Reis-Neto and Odirlei André Monticielo and Valéria Valim and Gecilmara Salviato Pileggi and Marcelo de Medeiros Pinheiro},
  journal = {Vaccines},
  year = {2026},
  month = oct,
  doi = {10.3390/vaccines14100913},
  url = {https://europepmc.org/article/MED/42931442},
  note = {CC BY},
}

TY  - JOUR
TI  - Immunogenicity, Safety, and Clinical Outcomes Following Homologous and Heterologous SARS-CoV-2 Vaccination Regimens in Patients with Axial Spondyloarthritis and Psoriatic Arthritis: A Prospective Observational Study from the SAFER Cohort.
AU  - Vanessa de Oliveira Magalhães
AU  - Priscila Dias Cardoso Ribeiro
AU  - Flávia Maria Matos Melo Campos Peixoto
AU  - Erika Biegelmeyer
AU  - Mariana Freitas de Aguiar
AU  - Cristiane Kayser
AU  - Alexandre Wagner Silva de Souza
AU  - Charlles Heldan de Moura Castro
AU  - Ketty Lysie Libardi Lira Machado
AU  - José Geraldo Mill
AU  - Nésio Fernandes de Medeiros Junior
AU  - Danielle Cristina Filgueira Alves Batista
AU  - Rebeca Silva Moreira da Fraga
AU  - Thaisa de Moraes Ribeiro Espirito Santo
AU  - Samira Tatiyama Miyamoto
AU  - Gabriel Smith Sobral Vieira
AU  - Pietra Zava Lorencini
AU  - Bárbara Oliveira Souza
AU  - Heitor Filipe Surlo
AU  - Anna Carolina Simões Moulin
AU  - Paula Dos Santos Athayde
AU  - Mariana de Oliveira Macabú
AU  - Sandra Lúcia Euzébio Ribeiro
AU  - Raquel Lima de Lima
AU  - Natália Seixas de Melo
AU  - Russian Teixeira Rebello
AU  - Marcos Mavignier Sousa Dias
AU  - Jonathan Willian da Silva Rodrigues
AU  - Camila Maria Paiva França Telles
AU  - Natália Sarzi Sartori
AU  - Regiane Lima
AU  - Rodrigo Poubel Vieira de Rezende
AU  - Katia Lino Baptista
AU  - Rodrigo Cutrim Gaudio
AU  - Ana Karla Guedes de Melo
AU  - Valéria Bezerra da Silva
AU  - Vitor Alves Cruz
AU  - Jozelia Rêgo
AU  - Rejane Maria Rodrigues de Abreu Vieira
AU  - Adah Sophia Rodrigues Vieira
AU  - Adriana Maria Kakehasi
AU  - Anna Carolina Faria Moreira Gomes Tavares
AU  - Artur José Azevedo Pereira
AU  - Renata Henriques de Azevedo
AU  - Valderilio Feijó Azevedo
AU  - Olindo Assis Martins-Filho
AU  - Vanessa Peruhype-Magalhães
AU  - Emilia Inoue Sato
AU  - Ricardo Machado Xavier
AU  - Andréa Teixeira-Carvalho
AU  - Viviane Angelina de Souza
AU  - Gilda Aparecida Ferreira
AU  - Edgard Torres Dos Reis-Neto
AU  - Odirlei André Monticielo
AU  - Valéria Valim
AU  - Gecilmara Salviato Pileggi
AU  - Marcelo de Medeiros Pinheiro
PY  - 2026
DA  - 2026/10/20
JO  - Vaccines
DO  - 10.3390/vaccines14100913
UR  - https://europepmc.org/article/MED/42931442
AB  - Background/objectives  Patients with spondyloarthritis (SpA) frequently receive immunomodulatory therapies that may influence vaccine-induced immune responses. However, evidence comparing the immunogenicity, safety, and clinical outcomes following homologous and heterologous SARS-CoV-2 vaccination regimens in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) remains limited.Methods  This observational study was conducted within the Brazilian multicenter SAFER cohort and included adults with axSpA or PsA who received three doses of SARS-CoV-2 vaccines through the Brazilian National Immunization Program. The primary outcome was humoral immunogenicity, assessed by anti-receptor-binding domain (anti-RBD) IgG geometric mean titers (GMTs). Clinical outcomes, disease activity, and safety were evaluated throughout follow-up.Results  Ninety patients (axSpA = 69; PsA = 21) were included. Antibody titers increased progressively after vaccination, with GMTs rising from 6.70 BAU/mL at baseline to 907.72 BAU/mL after the additional dose. Humoral responses were comparable between axSpA and PsA throughout follow-up. Participants with previous SARS-CoV-2 exposure consistently exhibited higher antibody responses than infection-naïve individuals. Although ChAdOx1-S elicited stronger early humoral responses than CoronaVac, heterologous regimens incorporating a BNT162b2 additional dose produced the highest post-additional-dose antibody concentrations. Serological response rates reached 100% after the additional dose, irrespective of disease subtype or vaccination regimen. Biologic disease-modifying antirheumatic drugs (bDMARDs), including TNF inhibitors, were not significantly associated with reduced antibody responses. Only four COVID-19 cases occurred during follow-up, with no hospitalizations or deaths. Disease activity remained stable, and adverse events were predominantly mild and self-limited.Conclusions  SARS-CoV-2 vaccination was safe and highly immunogenic in patients with axSpA and PsA, without compromising disease activity control. Heterologous vaccination regimens incorporating a BNT162b2 additional dose elicited the strongest humoral immune responses. These findings provide prospective real-world evidence supporting optimized additional-dose strategies and may inform future vaccination approaches for patients with SpA.
SN  - 2076-393X
ER  -