旨在评估接受苏金单抗 (SEC) 的脊柱关节炎 (SpA) 患者与肿瘤坏死因子抑制剂 (TNFi) 和免疫功能正常对照相比对 BNT162b2 mRNA 疫苗的体液反应。连续接受 SEC 治疗的银屑病关节炎或中轴型 SpA 患者 (n=37) ）或 TNFi（单一疗法 n = 109，甲氨蝶呤 [MTX] n = 16）、免疫功能正常的对照（n = 122）和接受 TNFi 的类风湿性关节炎（RA）患者（对照；n = 50）接种了两剂或三剂疫苗BNT162b2 疫苗。我们评估了体液反应、不良事件和疾病活动，并监测了疫苗接种后的突破性 COVID-19。两剂疫苗方案在所有研究组中均诱导了可比较的血清阳性反应。 SEC 组的 S1/S2 抗体滴度（以 BAU/mL 计）高于 TNF-MTX-SpA 和 TNF-RA 组（192.5±68.4，vs104.6±46.9，p<0.001，和 143.1±81.9，p =0.004）。 6 个月后，SEC、免疫活性、TNFi 单一疗法 -SpA 组的比例分别为 96.3%、96.6% 和 80.9% (p=0.10)； TNFi-MTX-SpA 组为 66.7% (p=0.03)； TNFi-RA 组中 63.0% (p=0.004) 仍保持血清反应阳性。 TNFi 组的 S1/S2 效价下降幅度比 SEC 组更剧烈。第三次给药后，100% 的 SpA 和免疫活性组以及 88.9% 的 TNFi-RA (p=0.25) 组呈血清阳性。 TNFi 组的突破性 COVID-19 感染率高于 SEC 组（36.0%-37.5% vs 10.8%）。疫苗接种后疾病活动和不良事件没有观察到显着的组间差异。SEC 不会干扰 SpA 患者对 BNT162b2 疫苗的免疫原性反应；然而，TNFi 与较低的 S1/S2 抗体滴度、较快的下降和较高的突破性感染率相关。

To assess the humoral response to the BNT162b2 mRNA vaccine among patients with spondyloarthritis (SpA) receiving secukinumab (SEC) compared to tumor necrosis factor inhibitors (TNFi), and immunocompetent controls.Consecutive patients with psoriatic arthritis or axial SpA receiving SEC (n=37) or TNFi (monotherapy n=109, with methotrexate [MTX] n=16), immunocompetent controls (n=122) and patients with rheumatoid arthritis (RA) receiving TNFi (controls; n=50) were vaccinated with two or three doses of the BNT162b2 vaccine. We evaluated humoral response, adverse events and disease activity, and monitored for breakthrough COVID-19 post-vaccination.The two-dose vaccine regimen induced a comparable seropositive response in all study groups. S1/S2 antibody titers (in BAU/mL) were higher in the SEC group versus the TNF-MTX-SpA and TNF-RA groups (192.5±68.4, versus104.6±46.9, p<0.001, and 143.1±81.9, p=0.004). After 6 months, 96.3%, 96.6%, and 80.9% of the SEC, immunocompetent, TNFi-monotherapy -SpA groups (p=0.10), respectively; 66.7% of TNFi-MTX-SpA group (p=0.03); and 63.0% of TNFi- RA group (p=0.004) remained seropositive. S1/S2 titer decline was steeper in the TNFi groups than the SEC group. After the third dose, 100% of the SpA and immunocompetent and 88.9% of TNFi-RA (p=0.25) groups were seropositive. Rate of breakthrough COVID-19 infection was higher in the TNFi groups than in the SEC group (36.0%-37.5% vs 10.8%). No significant between-group differences were observed for post-vaccination disease activity and adverse events.SEC did not interfere with the immunogenic response to BNT162b2 vaccine in patients with SpA; however, TNFi was associated with lower S1/S2-antibody titers, faster decline, and higher rate of breakthrough infections.