A NEW study has found that patients with rheumatic diseases treated with Janus kinase inhibitors (JAKi) may have a reduced T cell response to SARS-CoV-2 vaccination compared to those receiving tumor necrosis factor inhibitors (TNFi).
The cross-sectional study compared 22 patients on JAKi therapy with 16 on TNFi who had received two COVID-19 vaccine doses. Researchers evaluated T cell responses by stimulating peripheral blood mononuclear cells (PBMCs) with SARS-CoV-2 spike protein peptides and measuring interferon gamma (IFNγ) production by CD4+ T cells.
Results showed that only 50% of patients in the JAKi group mounted a detectable T cell response, compared with 81.3% in the TNFi group. Moreover, the overall percentage of responsive CD4+ T cells was significantly lower in JAKi-treated patients (p=0.021). Interestingly, antibody responses—including anti-spike IgG levels—were comparable between both groups.
The findings suggest that while JAKi-treated patients can generate adequate antibody protection, their cellular immune response may be compromised, potentially affecting the durability and breadth of immunity against evolving viral variants.
The authors emphasize the need for further research to understand the clinical implications of impaired T cell responses in this population, particularly in the context of ongoing vaccination strategies for immunosuppressed patients.
Reference
Hüper S et al. Comparison of T cell response to vaccination in rheumatic patients treated with Janus kinase inhibitors and TNF inhibitors. BMC Rheumatol. 2025;DOI: 10.1186/s41927-025-00542-7.
