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Clinical Research and Public HealthIn-Press PreviewCOVID-19Vaccines Open Access | 10.1172/jci.insight.191266

Prospective SARS-CoV-2 additional vaccination in immunosuppressant-treated individuals with autoimmune diseases in a randomized controlled trial

Meggan Mackay,1 Catriona A. Wagner,2 Ashley Pinckney,3 Jeffrey A. Cohen,4 Zachary S. Wallace,5 Arezou Khosroshahi,6 Jeffrey A. Sparks,7 Sandra Lord,8 Amit Saxena,9 Roberto Caricchio,10 Alfred H.J. Kim,11 Diane L. Kamen,12 Fotios Koumpouras,13 Anca D. Askanase,14 Kenneth Smith,2 Joel M. Guthridge,2 Gabriel Pardo,2 Yang Mao-Draayer,2 Susan Macwana,2 Sean McCarthy,15 Matthew A. Sherman,15 Sanaz Daneshfar Hamrah,15 Maria Veri,15 Sarah Walker,3 Kate York,3 Sara K. Tedeschi,7 Jennifer Wang,16 Gabrielle E. Dziubla,16 Mike Castro,16 Robin Carroll,16 Sandeep R. Narpala,16 Bob C. Lin,16 Leonid Serebryannyy,16 Adrian B. McDermott,16 William T. Barry,3 Ellen Goldmuntz,15 James McNamara,15 Aimee S. Payne,17 Amit Bar-Or,17 Dinesh Khanna,18 and Judith A. James2

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Mackay, M. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Wagner, C. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Pinckney, A. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Cohen, J. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Wallace, Z. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Khosroshahi, A. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Sparks, J. in: PubMed | Google Scholar |

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Lord, S. in: PubMed | Google Scholar |

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Saxena, A. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Caricchio, R. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Kim, A. in: PubMed | Google Scholar |

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Koumpouras, F. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

Find articles by Askanase, A. in: PubMed | Google Scholar

1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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1Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, United States of America

2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, United States of America

3Rho Inc., Durham, United States of America

4Neurologic Institute, Cleveland Clinic, Cleveland, United States of America

5Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, United States of America

6Emory Univerisity School of Medicine, Atlanta, United States of America

7Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, United States of America

8Center for Interventional Immunology, Benaroya Research Institute, Seattle, United States of America

9Division of Rheumatology, Department of Medicine, New York University Langone School of Medicine, New York, United States of America

10Division of Rheumatology, University of Massachusetts Chan Medical School, Worchester, United States of America

11Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, United States of America

12Medical University of South Carolina, Charleston, United States of America

13Department of Internal Medicine, Section of Rheumatology, Allergy and Immunol, Yale University School of Medicine, New Haven, United States of America

14Department of Medicine, Columbia University Irving Medical Center, New York, United States of America

15Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

16Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

17Department of Dermatology, Columbia University, New York, United States of America

18Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America

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Published November 25, 2025 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.191266.
Copyright © 2025, Mackay et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published November 25, 2025 - Version history
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Abstract

BACKGROUND. Individuals with autoimmune diseases (AD) on immunosuppressants often have suboptimal responses to COVID-19 vaccine. We evaluated the efficacy and safety of additional COVID-19 vaccines in those treated with mycophenolate mofetil/mycophenolic acid (MMF/MPA), methotrexate (MTX), and B cell-depleting therapy (BCDT), including the impact of withholding MMF/MPA and MTX.

METHODS. In this open-label, multicenter, randomized trial, 22 participants taking MMF/MPA, 26 taking MTX, and 93 treated with BCDT who had suboptimal antibody responses to initial COVID-19 vaccines (2 doses of BNT162b2 or mRNA-1273 or 1 dose of AD26.COV2.S) received an additional homologous vaccine. Participants taking MMF/MPA and MTX were randomized (1:1) to continue or withhold treatment around vaccination. The primary outcome was the change in anti-Wuhan-Hu-1 receptor-binding domain (RBD) concentrations at 4 weeks post-additional vaccination. Secondary outcomes included adverse events, COVID-19 , and AD activity through 48 weeks.

RESULTS. Additional vaccination increased anti-RBD concentrations in participants taking MMF/MPA and MTX , irrespective of immunosuppressant withholding. BCDT-treated participants also demonstrated increased anti-RBD concentrations, albeit lower than MMF/MPA- and MTX-treated cohorts. COVID-19 occurred in 33% of participants; infections were predominantly mild and included only three non-fatal hospitalizations. Additional vaccination was well-tolerated, with low frequencies of severe disease flares and adverse events.

CONCLUSION. Additional COVID-19 vaccination is effective and safe in individuals with ADs treated with immunosuppressants, regardless of whether MMF/MPA or MTX is withheld.

TRIAL REGISTRATION. ClinicalTrials.gov (NCT05000216; registered August 6, 2021: https://clinicaltrials.gov/ct2/show/NCT05000216)

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