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Global recognition for West Midlands-led study

The Royal Wolverhampton NHS Trust and partners at the Universities of Birmingham and Wolverhampton and the NIHR Clinical Research Network West Midlands (CRN WM) have presented important research findings at the American Society of Haematology’s (ASH) annual meeting – a prestigious event which invites experts from around the world to network and share good practice.

The meeting, which took place from 11-14 December in Atlanta, USA, hosted over 30,000 people with attendees joining both in person and online. As part of the four-day programme, the Trust and partners were invited to present its findings from a study looking to determine the impact of a particular drug on the immune response of patients following COVID-19 vaccination. The final results of this study have been published in the journal Clinical and Experimental Immunology.

The study, entitled ‘SARS-CoV-2 vaccine responses following CD20-depletion treatment in patients with haematological and rheumatological disease: a West Midlands Research Consortium study’, was led by Professor Supratik Basu, Consultant Haematologist and Researcher at the University of Wolverhampton, Professor Mark Drayson and Dr Adrian Shields from University of Birmingham, who queried if a drug called Rituximab, typically used to treat certain blood cancers and types of arthritis, may hinder the effectiveness of COVID-19 vaccines.

Dr Basu explains: “This particular drug targets B cells which normally produce antibodies. The hypothesis was that it might inadvertently affect the COVID-19 vaccine response, which may leave patients very vulnerable to serious illness.

“These patients are already considered to be high-risk, and therefore it seemed sensible to determine whether the treatment for their pre-existing condition was stopping the body from producing the antibodies it needs to fight the virus. Here we could establish if further vaccination was required or if alternative protection was needed.”

The study ran for a period of three months in 2021 with 150 patients taking part. The results showed only 30% of patients who had been vaccinated within six months of also receiving rituximab developed antibodies in response to the vaccine.

“While the rate of antibodies in this cohort was extremely low, this should alert clinicians to prioritise these patients for their third COVID-19 vaccine, while also giving important reminders about precautions such as hand-washing and social distancing,” added Dr Basu.

First and co-corresponding author Dr Adrian Shields, a Clinical Immunologist at the University of Birmingham, said: “Rituximab is used all over the world to treat blood cancers and inflammatory diseases. We now know that its use is associated with poor responses to new vaccines. The results from our study emphasise how important it is to undertake further research to improve our understanding of how to use vaccines to achieve the best possible protection for our most clinically vulnerable patients.”

Co-corresponding author Mark Drayson, Professor of Clinical Immunodiagnostics at the University of Birmingham and Honorary Consultant Immunologist at UHB, added: “Our research provides important observations, which may suggest that additional immunisations could be necessary at least six months after treatment with drugs that deplete B cells to optimise vaccine responsiveness. The monitoring of how a patient’s immune response is rebuilding following treatment may also help to ensure optimal vaccine timing. We would also recommend that individuals who do not respond to COVID-19 vaccines should be evaluated further for secondary immunodeficiency, particularly if treatments that deplete B cells were last administered 18 months or more prior to vaccination.”

“The interest from ASH shows you how a local study can make an impact on a global scale – it really is worth investigating those theories! Thanks to the support of the Trust’s research team, the CRN and the universities, who together enabled the research to take place.”

Pauline Boyle, Chief Operating Officer, CRN West Midlands said: “This is a fantastic achievement which shows what can be achieved when people work together. Well done to all involved."