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Antibody responses to influenza vaccine in patients on biological therapy: Results of RIER cohort study

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  • Antibody responses to influenza vaccine in patients on biological therapy: Results of RIER cohort study

    Med Clin (Barc). 2019 May 3. pii: S0025-7753(19)30130-7. doi: 10.1016/j.medcli.2019.02.003. [Epub ahead of print]
    Antibody responses to influenza vaccine in patients on biological therapy: Results of RIER cohort study.

    [Article in English, Spanish]
    Richi P1, Martín MD2, Navío MT3, González-Hombrado L4, Salido M5, Llorente J6, Thuissard-Vasallo I7, Alcocer P8, Saa-Requejo CM9, Jiménez-Diaz A10, Cebrián L3, Lojo L3, García-Castro M4, Sanz-Rosa D7, Castro P5, Fernández-Rodríguez S11, Martínez de Aramayona MJ11, Steiner M10, Cobo T10, García-Fernández C9, Fernández-Castro M10, Illera Ó10, Valverde R12, Muñoz-Fernández S10.
    Author information

    Abstract

    BACKGROUND AND OBJECTIVES:

    Influenza vaccine is recommended for patients with autoimmune inflammatory rheumatic diseases who receive biological therapy. To evaluate if biological therapy impairs immunization after seasonal influenza vaccine.
    MATERIAL AND METHODS:

    Patients with inflammatory arthopathies, psoriasis, inflammatory bowel disease or connective tissue diseases who were receiving or were going to initiate biological therapy were included and vaccinated during 2014-2015 influenza season. ELISA was used to measure influenza antigen A and B antibodies, before and after vaccination. Demographic parameters, diagnosis and kind of treatment were recorded and their influence on the final serological status against influenza was studied.
    RESULTS:

    253 subjects were analyzed. After vaccination, 77% of participants presented detectable antibodies against antigen A and 50.6% of them had detectable antibodies against antigen B. Final seropositivity rate against antigen B antibodies increased from baseline (50.6% vs 43.5%, p<0.001). Anti-TNF drugs were associated with better response and rituximab with the worst (79.2% vs 55.0% for final seropositivity against antigen A, p=0.020). Vaccine response in the rituximab group tended to improve when the interval between the drug administration and the vaccination was at least 12 weeks (seropositivity rate 80.0% in those with the longer interval vs 25.0% in the other group, p=0.054).
    CONCLUSIONS:

    Among the patients on biological therapy vaccinated against influenza, anti-TNF therapy was identified as a predictive factor of final seropositivity. Rituximab presented a lower rate of final seropositivity, which could be increased with an accurate administration schedule.
    Copyright © 2019 Elsevier España, S.L.U. All rights reserved.


    KEYWORDS:

    Anti-TNF; Autoimmune inflammatory diseases; Biological therapy; Enfermedades inflamatorias autoinmunes; Influenza vaccine; Rituximab; Terapia biológica; Vacuna contra la gripe

    PMID: 31060878 DOI: 10.1016/j.medcli.2019.02.003
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