tetano
Editor, Senior Moderator
Rheumatology (Oxford). 2011 Dec 14. [Epub ahead of print]
Protective effect of A/H1N1 vaccination in immune-mediated disease--a prospectively controlled vaccination study.
Adler S, Krivine A, Weix J, Rozenberg F, Launay O, Huesler J, Guillevin L, Villiger PM.
Source
Department of Rheumatology, Clinical Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland, Laboratory of Virology, P?le Biologie Pharmacie Pathologie, H?pital Cochin, Assistance Publique, H?pitaux de Paris, Paris, France, Department of Rheumatology and Clinical Immunology, Charit? University, Berlin, Germany, Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland and Department of Internal Medicine, H?pital Cochin, Assistance Publique, H?pitaux de Paris, INSERM 1060, Universit? Paris Descartes, Paris, France.
Abstract
Objectives. To assess the 2009 influenza vaccine A/H1N1 on antibody response, side effects and disease activity in patients with immune-mediated diseases.Methods. Patients with RA, SpA, vasculitis (VAS) or CTD (n = 149) and healthy individuals (n = 40) received a single dose of adjuvanted A/H1N1 influenza vaccine. Sera were obtained before vaccination, and 3 weeks, 6 weeks and 6 months thereafter. A/H1N1 antibody titres were measured by haemagglutination inhibition (HAI) assay. Seroprotection was defined as specific antibody titre ≥ 1 : 40, seroconversion as 4-fold increase in antibody titre.Results. Titres increased significantly in patients and controls with a maximum at Week 3, declining to levels below protection at Month 6 (P < 0.001). Seroprotection was more frequently reached in SpA and CTD than in RA and VAS (80 and 82% and 57 and 47%, respectively). There was a significantly negative impact by MTX (P < 0.001), rituximab (P = 0.0031) and abatacept (P = 0.045). Other DMARDs, glucocorticoids and TNF blockers did not significantly suppress response (P = 0.06, 0.11 and 0.81, respectively). A linear decline in response was noted in patients with increasing age (P < 0.001). Disease reactivation possibly related to vaccination was suspected in 8/149 patients. No prolonged side effects or A/H1N1 infections were noted.Conclusions. The results show that vaccination response is a function of disease type, intensity and character of medication and age. A single injection of adjuvanted influenza vaccine is sufficient to protect a high percentage of patients. Therefore, differential vaccination recommendations might in the future reduce costs and increase vaccination acceptance.
PMID:
22171015
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22171015
Protective effect of A/H1N1 vaccination in immune-mediated disease--a prospectively controlled vaccination study.
Adler S, Krivine A, Weix J, Rozenberg F, Launay O, Huesler J, Guillevin L, Villiger PM.
Source
Department of Rheumatology, Clinical Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland, Laboratory of Virology, P?le Biologie Pharmacie Pathologie, H?pital Cochin, Assistance Publique, H?pitaux de Paris, Paris, France, Department of Rheumatology and Clinical Immunology, Charit? University, Berlin, Germany, Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland and Department of Internal Medicine, H?pital Cochin, Assistance Publique, H?pitaux de Paris, INSERM 1060, Universit? Paris Descartes, Paris, France.
Abstract
Objectives. To assess the 2009 influenza vaccine A/H1N1 on antibody response, side effects and disease activity in patients with immune-mediated diseases.Methods. Patients with RA, SpA, vasculitis (VAS) or CTD (n = 149) and healthy individuals (n = 40) received a single dose of adjuvanted A/H1N1 influenza vaccine. Sera were obtained before vaccination, and 3 weeks, 6 weeks and 6 months thereafter. A/H1N1 antibody titres were measured by haemagglutination inhibition (HAI) assay. Seroprotection was defined as specific antibody titre ≥ 1 : 40, seroconversion as 4-fold increase in antibody titre.Results. Titres increased significantly in patients and controls with a maximum at Week 3, declining to levels below protection at Month 6 (P < 0.001). Seroprotection was more frequently reached in SpA and CTD than in RA and VAS (80 and 82% and 57 and 47%, respectively). There was a significantly negative impact by MTX (P < 0.001), rituximab (P = 0.0031) and abatacept (P = 0.045). Other DMARDs, glucocorticoids and TNF blockers did not significantly suppress response (P = 0.06, 0.11 and 0.81, respectively). A linear decline in response was noted in patients with increasing age (P < 0.001). Disease reactivation possibly related to vaccination was suspected in 8/149 patients. No prolonged side effects or A/H1N1 infections were noted.Conclusions. The results show that vaccination response is a function of disease type, intensity and character of medication and age. A single injection of adjuvanted influenza vaccine is sufficient to protect a high percentage of patients. Therefore, differential vaccination recommendations might in the future reduce costs and increase vaccination acceptance.
PMID:
22171015
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22171015