tetano
Editor, Senior Moderator
Arthritis Care Res (Hoboken). 2012 Sep 4. doi: 10.1002/acr.21838. [Epub ahead of print]
Abatacept severely reduces the immune response to pandemic 2009 influenza A/H1N1 vaccination in patients with rheumatoid arthritis.
Ribeiro AC, Laurindo IM, Guedes LK, Saad CG, Moraes JC, Silva CA, Bonfa E.
Source
Division of Rheumatology, Faculdade de Medicina da Universidade de S?o Paulo, S?o Paulo, Brazil. anademedeiros@yahoo.com.
Abstract
OBJECTIVE:
To evaluate the influence of abatacept and associated contributing factors on pandemic 2009 influenza A/H1N1 vaccine immunogenicity in rheumatoid arthritis (RA) patients.
METHODS:
The response to a non-adjuvanted monovalent pandemic 2009 influenza A/H1N1 killed virus vaccine was analyzed in 11 RA patients using abatacept (RA-ABA), most with concomitant non-biologic DMARDS, compared to 33 age-matched RA patients on methotrexate (RA-MTX) and 55 healthy controls (controls), all without previous seroprotection. Clinical and laboratory evaluations were performed before and 21 days after vaccination. Anti-influenza antibody titers were measured by hemagglutination inhibition assay. Seroprotection (antibody titers ≥1:40) and the factor increase in the geometric mean titers (FI-GMT) were calculated. Prevaccination lymphocyte counts and gammaglobulin levels were determined.
RESULTS:
Gender distribution, disease duration and DAS28 were similar in the RA groups (p>0.05). After vaccination, seroprotection was significantly reduced in RA-ABA compared to RA-MTX (9 vs. 58%; p=0.006) and controls (69%; p≤0.001). FI-GMT was severely reduced in RA-ABA compared to RA-MTX [1.8(1.4-2.3) vs. 8.7(5.2-17.4); p<0.001] and controls [11.5(8.0-16.7); p≤0.001]. Lymphocyte counts were comparable in RA groups (p>0.05), but RA-ABA patients had slightly lower gammaglobulin levels than RA-MTX patients [0.9(0.6-1.8) vs. 1.2(0.8-1.7) g/dL; p=0.03], although almost all within the normal range values.
CONCLUSION:
The current study established that abatacept in association with traditional DMARDs significantly reduces the humoral response to pandemic 2009 influenza A/H1N1 vaccine in RA patients. The results suggest an influence of co-stimulatory modulation in humoral response to this vaccine.
Copyright ? 2012 by the American College of Rheumatology.
PMID:
22949223
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22949223
Abatacept severely reduces the immune response to pandemic 2009 influenza A/H1N1 vaccination in patients with rheumatoid arthritis.
Ribeiro AC, Laurindo IM, Guedes LK, Saad CG, Moraes JC, Silva CA, Bonfa E.
Source
Division of Rheumatology, Faculdade de Medicina da Universidade de S?o Paulo, S?o Paulo, Brazil. anademedeiros@yahoo.com.
Abstract
OBJECTIVE:
To evaluate the influence of abatacept and associated contributing factors on pandemic 2009 influenza A/H1N1 vaccine immunogenicity in rheumatoid arthritis (RA) patients.
METHODS:
The response to a non-adjuvanted monovalent pandemic 2009 influenza A/H1N1 killed virus vaccine was analyzed in 11 RA patients using abatacept (RA-ABA), most with concomitant non-biologic DMARDS, compared to 33 age-matched RA patients on methotrexate (RA-MTX) and 55 healthy controls (controls), all without previous seroprotection. Clinical and laboratory evaluations were performed before and 21 days after vaccination. Anti-influenza antibody titers were measured by hemagglutination inhibition assay. Seroprotection (antibody titers ≥1:40) and the factor increase in the geometric mean titers (FI-GMT) were calculated. Prevaccination lymphocyte counts and gammaglobulin levels were determined.
RESULTS:
Gender distribution, disease duration and DAS28 were similar in the RA groups (p>0.05). After vaccination, seroprotection was significantly reduced in RA-ABA compared to RA-MTX (9 vs. 58%; p=0.006) and controls (69%; p≤0.001). FI-GMT was severely reduced in RA-ABA compared to RA-MTX [1.8(1.4-2.3) vs. 8.7(5.2-17.4); p<0.001] and controls [11.5(8.0-16.7); p≤0.001]. Lymphocyte counts were comparable in RA groups (p>0.05), but RA-ABA patients had slightly lower gammaglobulin levels than RA-MTX patients [0.9(0.6-1.8) vs. 1.2(0.8-1.7) g/dL; p=0.03], although almost all within the normal range values.
CONCLUSION:
The current study established that abatacept in association with traditional DMARDs significantly reduces the humoral response to pandemic 2009 influenza A/H1N1 vaccine in RA patients. The results suggest an influence of co-stimulatory modulation in humoral response to this vaccine.
Copyright ? 2012 by the American College of Rheumatology.
PMID:
22949223
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22949223