tetano
Editor, Senior Moderator
Arthritis Care Res (Hoboken). 2013 Dec 10. doi: 10.1002/acr.22246. [Epub ahead of print]
Effect of methotrexate, anti-TNFα and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: A systematic review and meta-analysis.
Hua C, Barnetche T, Combe B, Morel J.
Author information
Abstract
OBJECTIVE:
To assess the current literature on the impact of rheumatoid arthritis (RA) treatments on the humoral response to pneumococcal and influenza vaccines.
METHODS:
We systematically searched the literature for studies evaluating the immune response to vaccines in RA patients receiving methotrexate (MTX) and/or biologics. The efficacy of vaccination, assessed by response rate based on increased antibody titers before and 3 to 6 weeks after vaccination, was extracted by one investigator and verified by another.
RESULTS:
12 studies were included. RA patients mainly received MTX, anti-TNFα or rituximab (RTX). Influenza vaccination response was reduced for RTX (43 patients. Pooled odds-ratio (OR), 0.44 [95% CI, 0.17-1.12] for strain H1N1, 0.11 [0.04-0.31] for H3N2, 0.29 [0.10-0.81] for B) but not anti-TNFα (308 patients. OR, 0.93 [0.36-2.37] for H1N1, 0.79 [0.34-1.83] for H3N2, 0.79 [0.37-1.70] for B). For MTX, results differ depending on the method of analysis (222 patients. OR, 0.35 [0.18-0.66] for at least 2 strains, ORs close to 1.0 in the single strain analysis). Pneumococcal vaccination response was reduced for 139 patients receiving MTX compared to controls (OR, 0.33 [0.20-0.54] for serotype 6B, 0.58 [0.36-0.94] for 23F) but not anti-TNFα (258 patients. OR, 0.96 [0.57-1.59] for 6B, 1.20 [0.57-2.54] for 23F). For RTX, response was reduced (88 patients. OR, 0.25 [0.11-0.58] for 6B and 0.21 [0.04-1.05] for 23F).
CONCLUSION:
MTX decreases humoral response to pneumococcal vaccine and may impair response to influenza vaccine. The immune response to both vaccines is reduced with RTX but not anti-TNFα therapy in RA patients. ? 2013 American College of Rheumatology.
Copyright ? 2013 American College of Rheumatology.
PMID:
24339395
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24339395
Effect of methotrexate, anti-TNFα and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: A systematic review and meta-analysis.
Hua C, Barnetche T, Combe B, Morel J.
Author information
Abstract
OBJECTIVE:
To assess the current literature on the impact of rheumatoid arthritis (RA) treatments on the humoral response to pneumococcal and influenza vaccines.
METHODS:
We systematically searched the literature for studies evaluating the immune response to vaccines in RA patients receiving methotrexate (MTX) and/or biologics. The efficacy of vaccination, assessed by response rate based on increased antibody titers before and 3 to 6 weeks after vaccination, was extracted by one investigator and verified by another.
RESULTS:
12 studies were included. RA patients mainly received MTX, anti-TNFα or rituximab (RTX). Influenza vaccination response was reduced for RTX (43 patients. Pooled odds-ratio (OR), 0.44 [95% CI, 0.17-1.12] for strain H1N1, 0.11 [0.04-0.31] for H3N2, 0.29 [0.10-0.81] for B) but not anti-TNFα (308 patients. OR, 0.93 [0.36-2.37] for H1N1, 0.79 [0.34-1.83] for H3N2, 0.79 [0.37-1.70] for B). For MTX, results differ depending on the method of analysis (222 patients. OR, 0.35 [0.18-0.66] for at least 2 strains, ORs close to 1.0 in the single strain analysis). Pneumococcal vaccination response was reduced for 139 patients receiving MTX compared to controls (OR, 0.33 [0.20-0.54] for serotype 6B, 0.58 [0.36-0.94] for 23F) but not anti-TNFα (258 patients. OR, 0.96 [0.57-1.59] for 6B, 1.20 [0.57-2.54] for 23F). For RTX, response was reduced (88 patients. OR, 0.25 [0.11-0.58] for 6B and 0.21 [0.04-1.05] for 23F).
CONCLUSION:
MTX decreases humoral response to pneumococcal vaccine and may impair response to influenza vaccine. The immune response to both vaccines is reduced with RTX but not anti-TNFα therapy in RA patients. ? 2013 American College of Rheumatology.
Copyright ? 2013 American College of Rheumatology.
PMID:
24339395
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/24339395