{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:02:37Z","timestamp":1789549357917,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s10067-026-08371-w","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:02:50Z","timestamp":1787310170000},"page":"5989-5997","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 outcomes among vaccinated and unvaccinated patients receiving disease-modifying antirheumatic drugs and biologic therapies: a retrospective multihospital cohort study"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4893-7638","authenticated-orcid":false,"given":"Dat","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijin","family":"Wert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"8","key":"8371_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12081295","volume":"12","author":"R Filip","year":"2022","unstructured":"Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK (2022) Global challenges to public health care systems during the COVID-19 pandemic: a review of pandemic measures and problems. J Pers Med 12(8):1295. https:\/\/doi.org\/10.3390\/jpm12081295","journal-title":"J Pers Med"},{"issue":"1","key":"8371_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07418-y","volume":"22","author":"P Ssentongo","year":"2022","unstructured":"Ssentongo P, Ssentongo AE, Voleti N, Groff D, Sun A, Ba DM, Nunez J, Parent LJ, Chinchilli VM, Paules CI (2022) SARS-CoV-2 vaccine effectiveness against infection, symptomatic and severe COVID-19: a systematic review and meta-analysis. BMC Infect Dis 22(1):439","journal-title":"BMC Infect Dis"},{"issue":"5","key":"8371_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9050467","volume":"9","author":"A Pormohammad","year":"2021","unstructured":"Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, Turner RJ (2021) Efficacy and safety of COVID-19 vaccines: a systematic review and meta-analysis of randomized clinical trials. Vaccines (Basel) 9(5):467","journal-title":"Vaccines (Basel)"},{"key":"8371_CR4","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1136\/annrheumdis-2021-220781","volume":"384","author":"LR Baden","year":"2021","unstructured":"Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech B et al (2021) Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 384:403\u2013416. https:\/\/doi.org\/10.1136\/annrheumdis-2021-220781","journal-title":"N Engl J Med"},{"key":"8371_CR5","doi-asserted-by":"publisher","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","volume":"383","author":"FP Polack","year":"2020","unstructured":"Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Marc GP, Moreira ED, Zerbini C et al (2020) Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med 383:2603\u20132615","journal-title":"N Engl J Med"},{"issue":"12","key":"8371_CR6","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1016\/s1473-3099(22)00506-0","volume":"22","author":"K Hardt","year":"2022","unstructured":"Hardt K, Vandebosch A, Sadoff J, Le Gars M, Truyers C, Lowson D, Van Dromme I, Vingerhoets J, Kamphuis T, Scheper G, Ruiz-Gui\u00f1az\u00fa J, Faust SN, Spinner CD, Schuitemaker H, Van Hoof J, Douoguih M, Struyf F, ENSEMBLE2 Study Group (2022) Efficacy, safety, and immunogenicity of a booster regimen of Ad26.COV2.S vaccine against COVID-19 (ENSEMBLE2): results of a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Infect Dis 22(12):1703\u20131715. https:\/\/doi.org\/10.1016\/s1473-3099(22)00506-0","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"8371_CR7","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1093\/cid\/ciae308","volume":"79","author":"M Boeckh","year":"2024","unstructured":"Boeckh M, Pergam SA, Limaye AP, Englund J, Corey L, Hill JA (2024) How immunocompromised hosts were left behind in the quest to control the COVID-19 pandemic. Clin Infect Dis 79(4):1018\u20131023. https:\/\/doi.org\/10.1093\/cid\/ciae308","journal-title":"Clin Infect Dis"},{"key":"8371_CR8","unstructured":"Case SM, Seo P (2026). What\u2019s new in rheumatology. UpToDate. Accessed 2026 Aug"},{"key":"8371_CR9","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1136\/annrheumdis-2019-216655","volume":"79","author":"JS Smolen","year":"2020","unstructured":"Smolen JS, Landew\u00e9 RBM, Bijlsma JWJ et al (2020) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 79:685\u2013699. https:\/\/doi.org\/10.1136\/annrheumdis-2019-216655","journal-title":"Ann Rheum Dis"},{"key":"8371_CR10","doi-asserted-by":"publisher","first-page":"e326","DOI":"10.1016\/s2214-109x(21)00593-3","volume":"10","author":"EPK Parker","year":"2022","unstructured":"Parker EPK, Desai S, Marti M, Nohynek H, Kaslow DC, Kochhar S, O\u2019Brien KL, Hombach J, Wilder-Smith A (2022) Response to additional COVID-19 vaccine doses in people who are immunocompromised: a rapid review. Lancet Glob Health 10:e326\u2013e328. https:\/\/doi.org\/10.1016\/s2214-109x(21)00593-3","journal-title":"Lancet Glob Health"},{"key":"8371_CR11","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1136\/annrheumdis-2021-220781","volume":"80","author":"R Mrak","year":"2021","unstructured":"Mrak R, Tobudic S, Koblischke M, Graninger M, Brauer R, Nigg C, Pongratz G, Steiner G, Wagner C (2021) SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity. Ann Rheum Dis 80:1345\u20131350. https:\/\/doi.org\/10.1136\/annrheumdis-2021-220781","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"8371_CR12","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1136\/annrheumdis-2021-222045","volume":"81","author":"C Shen","year":"2022","unstructured":"Shen C, Risk M, Schiopu E, Hayek SS, Xie T, Holevinski L, Akin C, Freed G, Zhao L (2022) Efficacy of COVID-19 vaccines in patients taking immunosuppressants. Ann Rheum Dis 81(6):875\u2013880. https:\/\/doi.org\/10.1136\/annrheumdis-2021-222045","journal-title":"Ann Rheum Dis"},{"issue":"21","key":"8371_CR13","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1001\/jama.2021.7489","volume":"325","author":"BJ Boyarsky","year":"2021","unstructured":"Boyarsky BJ, Werbel WA, Avery RK, Tobian AAR, Massie AB, Segev DL, Garonzik-Wang JM (2021) Antibody response to 2-dose SARS-CoV-2 mRNA vaccine series in solid organ transplant recipients. JAMA 325(21):2204\u20132206. https:\/\/doi.org\/10.1001\/jama.2021.7489","journal-title":"JAMA"},{"issue":"9","key":"8371_CR14","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11091456","volume":"11","author":"A Widhani","year":"2023","unstructured":"Widhani A, Hasibuan AS, Rismawati R, Maria S, Koesnoe S, Hermanadi MI, Ophinni Y, Yamada C, Harimurti K, Sari ANL, Yunihastuti E, Djauzi S (2023) Efficacy, immunogenicity, and safety of COVID-19 vaccines in patients with autoimmune diseases: a systematic review and meta-analysis. Vaccines (Basel) 11(9):1456. https:\/\/doi.org\/10.3390\/vaccines11091456","journal-title":"Vaccines (Basel)"},{"issue":"11","key":"8371_CR15","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.7326\/m21-1757","volume":"174","author":"P Deepak","year":"2021","unstructured":"Deepak P, Kim W, Paley MA, Yang M, Carvidi AB, Demissie EG, El-Qunni AA, Haile A, Huang K, Kothari H et al (2021) Effect of immunosuppression on the immunogenicity of mRNA vaccines to SARS-CoV-2: a prospective cohort study. Ann Intern Med 174(11):1572\u20131585. https:\/\/doi.org\/10.7326\/m21-1757","journal-title":"Ann Intern Med"},{"issue":"10","key":"8371_CR16","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1136\/annrheumdis-2021-220647","volume":"80","author":"V Furer","year":"2021","unstructured":"Furer V, Eviatar T, Zisman D, Peleg H, Paran D, Levartovsky D, Zisapel M, Elalouf O, Kaufman I, Meidan R et al (2021) Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study. Ann Rheum Dis 80(10):1330\u20131338. https:\/\/doi.org\/10.1136\/annrheumdis-2021-220647","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"8371_CR17","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1007\/s00296-024-05682-6","volume":"44","author":"L Palazzo","year":"2024","unstructured":"Palazzo L, Lindblom J, Kihlgren Olsson E, Nikiphorou E, Wincup C, Saha S, Shaharir SS, Katchamart W, Akarawatcharangura Goo P, Traboco L, Chen YM, Lilleker JB, Nune A, Pauling JD, Agarwal V, Dzifa D, Toro Guti\u00e9rrez CE, Caballero-Uribe CV, Chinoy H, Agarwal V, Gupta L, Parodis I (2024) Breakthrough SARS-CoV-2 infection in fully vaccinated patients with systemic lupus erythematosus: results from the COVID-19 vaccination in autoimmune disease (COVAD) study. Rheumatol Int 44(10):1923\u20131933. https:\/\/doi.org\/10.1007\/s00296-024-05682-6","journal-title":"Rheumatol Int"},{"key":"8371_CR18","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1038\/s41584-022-00755-x","volume":"18","author":"R Grainger","year":"2022","unstructured":"Grainger R, Kim AHJ, Conway R, Yazdany J, Robinson PC (2022) COVID-19 in people with rheumatic diseases: risks, outcomes, treatment considerations. Nat Rev Rheumatol 18:191\u2013204. https:\/\/doi.org\/10.1038\/s41584-022-00755-x","journal-title":"Nat Rev Rheumatol"},{"key":"8371_CR19","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01049","volume":"11","author":"G Siracusano","year":"2020","unstructured":"Siracusano G, Pastori C, Lopalco L (2020) Humoral immune responses in COVID-19 patients: a window on the state of the art. Front Immunol 11:1049. https:\/\/doi.org\/10.3389\/fimmu.2020.01049","journal-title":"Front Immunol"},{"issue":"10","key":"8371_CR20","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1136\/annrheumdis-2021-220626","volume":"80","author":"M Prendecki","year":"2021","unstructured":"Prendecki M, Clarke C, Edwards H, McIntyre S, Mortimer P, Gleeson S, Martin P, Thomson T, Randell P, Shah A, Singanayagam A, Lightstone L, Cox A, Kelleher P, Willicombe M, McAdoo SP (2021) Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression. Ann Rheum Dis 80(10):1322\u20131329. https:\/\/doi.org\/10.1136\/annrheumdis-2021-220626","journal-title":"Ann Rheum Dis"},{"key":"8371_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2022.104501","volume":"373","author":"D Mohanraj","year":"2022","unstructured":"Mohanraj D, Baldwin S, Singh S, Gordon A, Whitelegg A (2022) Cellular and humoral responses to SARS-CoV-2 vaccination in immunosuppressed patients. Cell Immunol 373:104501. https:\/\/doi.org\/10.1016\/j.cellimm.2022.104501","journal-title":"Cell Immunol"},{"issue":"4","key":"8371_CR22","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.eimc.2022.11.003","volume":"42","author":"E Varea-Jim\u00e9nez","year":"2024","unstructured":"Varea-Jim\u00e9nez E, Aznar Cano E, Vega-Piris L, Mart\u00ednez S\u00e1nchez EV, Mazagatos C, Garc\u00eda San Miguel Rodr\u00edguez-Alarc\u00f3n L, Casas I, Sierra Moros MJ, Iglesias-Caballero M, Vazquez-Mor\u00f3n S, Larrauri A, Monge S (2024) Comparative severity of COVID-19 cases caused by Alpha, Delta or Omicron SARS-CoV-2 variants and its association with vaccination. Enferm Infecc Microbiol Clin (Engl Ed) 42(4):187\u2013194. https:\/\/doi.org\/10.1016\/j.eimc.2022.11.003","journal-title":"Enferm Infecc Microbiol Clin (Engl Ed)"},{"issue":"12","key":"8371_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2025.106920","volume":"164","author":"C Teles","year":"2025","unstructured":"Teles C, Borges A, Magalh\u00e3es A, Barra C, Silva I, Tom\u00e9 P, Crespo J, Paiva A, Santos L (2025) Effectiveness and immunogenicity of SARS-CoV-2 booster vaccine in immunosuppressed systemic autoimmune disease patients: a prospective study. Med Clin (Barc) 164(12):106920. https:\/\/doi.org\/10.1016\/j.medcli.2025.106920","journal-title":"Med Clin (Barc)"},{"issue":"10","key":"8371_CR24","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines12030274","volume":"10","author":"RXL Yap","year":"2022","unstructured":"Yap RXL, Lai YW, Wei C, Ng JJW, Xu D, Feng S, Mu R, Thong BY-H, Xu C (2022) Impact of immunomodulatory therapy on COVID-19 vaccine response in patients with autoimmune inflammatory rheumatic diseases. Vaccines (Basel) 10(10):1617. https:\/\/doi.org\/10.3390\/vaccines12030274","journal-title":"Vaccines (Basel)"},{"key":"8371_CR25","unstructured":"Nimmana BK, Patel P (2024) Disease-modifying antirheumatic drugs (DMARDs). StatPearls. StatPearls Publishing"},{"key":"8371_CR26","unstructured":"Centers for Disease Control and Prevention (2025) Underlying conditions and the higher risk for severe COVID-19. Updated 6 February 2025. https:\/\/www.cdc.gov\/covid\/hcp\/clinical-care\/underlying-conditions.html. Accessed 1 Jan 2026."},{"issue":"688","key":"8371_CR27","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.adg2783","volume":"15","author":"P Schmidt","year":"2023","unstructured":"Schmidt P, Narayan K, Li Y, Kaku CI, Brown ME, Champney E, Walker LM (2023) Antibody-mediated protection against symptomatic COVID-19 can be achieved at low serum neutralizing titers. Sci Transl Med 15(688):eadg2783. https:\/\/doi.org\/10.1126\/scitranslmed.adg2783","journal-title":"Sci Transl Med"},{"issue":"4","key":"8371_CR28","doi-asserted-by":"publisher","first-page":"398","DOI":"10.4997\/jrcpe.2020.409","volume":"50","author":"K Talari","year":"2020","unstructured":"Talari K, Goyal M (2020) Retrospective studies: utility and caveats. J R Coll Physicians Edinb 50(4):398\u2013402. https:\/\/doi.org\/10.4997\/jrcpe.2020.409","journal-title":"J R Coll Physicians Edinb"},{"issue":"12","key":"8371_CR29","doi-asserted-by":"publisher","first-page":"3828","DOI":"10.1093\/rheumatology\/kead150","volume":"62","author":"M Rutter","year":"2023","unstructured":"Rutter M, Lanyon PC, Grainge MJ, Hubbard R, Bythell M, Stilwell P, Aston J, McPhail S, Stevens S, Pearce FA (2023) COVID-19 infection, admission and death and the impact of corticosteroids among people with rare autoimmune rheumatic disease during the second wave of COVID-19 in England: results from the RECORDER project. Rheumatology (Oxford) 62(12):3828\u20133837. https:\/\/doi.org\/10.1093\/rheumatology\/kead150","journal-title":"Rheumatology (Oxford)"},{"key":"8371_CR30","unstructured":"Al-Jandeel TJ, Al-Karawi AS, Abdulrazzaq OI, Tareq S (2023) An evaluation of laboratory tests for COVID-19 infection in patients residing in the Baghdad-Iraq. Int J Chem Biochem Sci 23(1)"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08371-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-026-08371-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08371-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:04:55Z","timestamp":1789545895000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-026-08371-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["8371"],"URL":"https:\/\/doi.org\/10.1007\/s10067-026-08371-w","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"12 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board of UPMC Central PA Region (IRB #24E045; approval: expedited review, minimal risk). Requirement for informed consent was waived due to the retrospective nature of the study. The study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics statement","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"None.","order":2,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}