tetano
Editor, Senior Moderator
Arthritis Rheum. 2011 Mar 7. doi: 10.1002/art.30325. [Epub ahead of print]
Impact of synthetic and biological disease modifying antirheumatic drugs on antibody responses to the ASO3-adjuvanted pandemic influenza vaccine.
Gabay C, Bel M, Combescure C, Ribi C, Meier S, Posfay-Barbe K, Grillet S, Seebach JD, Kaiser L, Wunderli W, Guerne PA, Siegrist CA; for the H1N1 study group..
Division of Rheumatology, Department of Internal Medicine, University Hospitals of Geneva & Faculty of Medicine, University of Geneva. cem.gabay@hcuge.ch.
Abstract
OBJECTIVES.: To identify the determinants of antibody responses to adjuvanted split influenza A(H1N1) vaccines in patients with inflammatory rheumatic diseases. METHODS.: This prospective single-center study enrolled 173 patients (rheumatoid arthritis: 82, spondyloarthropathies: 45, others: 46) and 138 controls who received 1 (controls) or 2 (patients) doses of adjuvanted influenza A/09/H1N1 vaccine. Antibody responses were measured by hemagglutination inhibition before and 3-4 weeks after each dose. Geometric mean titres (GMT) and seroprotection rates (GMT ≥ 40) were calculated. A comprehensive medical questionnaire was used to identify the determinants of vaccine responses and adverse events. RESULTS.: Baseline influenza A/09/H1N1 antibodies were low in patients and controls (HAI seroprotection rates: 14.2% and 14.8% ≥ 1:40, respectively). A significant response to dose 1 was observed in both groups. However, GMT (146 vs 340, P<0.001) and seroprotection rates (74.6% versus 87%, P<0.001) remained significantly lower in patients. The second dose markedly increased patients' antibody titers, which reached similar GMTs and seroprotection rate as elicited by a single dose in healthy controls. Multivariate regression analyses identified increasing age, the use of disease modifying anti-rheumatic drugs (DMARDs) (except hydroxychloroquine and sulfasalazine) and recent (< 3 months) B cell depletion, but not TNF-α antagonists, as the main determinants of vaccine responses. Immunization was well tolerated, without any adverse impact on disease activity. CONCLUSIONS.: DMARDs exert distinct influences on influenza vaccine responses in patients with inflammatory rheumatic diseases. Two doses of adjuvanted vaccine were necessary and sufficient to elicit similar responses in patients as 1 dose in healthy controls.
Copyright ? 2011 by the American College of Rheumatology.
PMID: 21384334 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21384334
Impact of synthetic and biological disease modifying antirheumatic drugs on antibody responses to the ASO3-adjuvanted pandemic influenza vaccine.
Gabay C, Bel M, Combescure C, Ribi C, Meier S, Posfay-Barbe K, Grillet S, Seebach JD, Kaiser L, Wunderli W, Guerne PA, Siegrist CA; for the H1N1 study group..
Division of Rheumatology, Department of Internal Medicine, University Hospitals of Geneva & Faculty of Medicine, University of Geneva. cem.gabay@hcuge.ch.
Abstract
OBJECTIVES.: To identify the determinants of antibody responses to adjuvanted split influenza A(H1N1) vaccines in patients with inflammatory rheumatic diseases. METHODS.: This prospective single-center study enrolled 173 patients (rheumatoid arthritis: 82, spondyloarthropathies: 45, others: 46) and 138 controls who received 1 (controls) or 2 (patients) doses of adjuvanted influenza A/09/H1N1 vaccine. Antibody responses were measured by hemagglutination inhibition before and 3-4 weeks after each dose. Geometric mean titres (GMT) and seroprotection rates (GMT ≥ 40) were calculated. A comprehensive medical questionnaire was used to identify the determinants of vaccine responses and adverse events. RESULTS.: Baseline influenza A/09/H1N1 antibodies were low in patients and controls (HAI seroprotection rates: 14.2% and 14.8% ≥ 1:40, respectively). A significant response to dose 1 was observed in both groups. However, GMT (146 vs 340, P<0.001) and seroprotection rates (74.6% versus 87%, P<0.001) remained significantly lower in patients. The second dose markedly increased patients' antibody titers, which reached similar GMTs and seroprotection rate as elicited by a single dose in healthy controls. Multivariate regression analyses identified increasing age, the use of disease modifying anti-rheumatic drugs (DMARDs) (except hydroxychloroquine and sulfasalazine) and recent (< 3 months) B cell depletion, but not TNF-α antagonists, as the main determinants of vaccine responses. Immunization was well tolerated, without any adverse impact on disease activity. CONCLUSIONS.: DMARDs exert distinct influences on influenza vaccine responses in patients with inflammatory rheumatic diseases. Two doses of adjuvanted vaccine were necessary and sufficient to elicit similar responses in patients as 1 dose in healthy controls.
Copyright ? 2011 by the American College of Rheumatology.
PMID: 21384334 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21384334