Abatacept and reduced immune response to pandemic 2009 influenza A/H1N1 vaccination in patients with rheumatoid arthritis

Ribeiro, Ana C.; Laurindo, Iêda Maria Magalhães; Guedes, Lissiane Karine Noronha; Saad, Carla G. S.; Moraes, José Reinaldo da Silva Cabral de; Silva, Clóvis A.; Bonfá, Eloísa

doi:10.1002/acr.21838

Cited by 101 publications

(72 citation statements)

References 16 publications

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“…Of note, vaccination strategies may be more challenging in abatacept-treated patients. Combination of abatacept and a conventional DMARD significantly reduced the response towards the 2009 influenza vaccine [101]. Similar data have been proposed for vaccination against pneumococcus pneumoniae [102,103].…”

Section: Abataceptsupporting

confidence: 64%

Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Older Rheumatoid Arthritis Patients: Staying the Distance

Ishchenko

Lories

2016

Drugs Aging

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The population of elderly individuals with rheumatoid arthritis is rapidly expanding, mainly due to the increased life expectancy. While targeted biological therapies are well established for the treatment of this disease, their use may be lower in elderly (> of 65 years old) and very elderly patients (> 75 years old) due to perceived higher risks for adverse events in this population taking into account comorbidity, polypharmacy and frailty. In this review we discuss available evidence for the use of biological therapies in this growing patient group with specific attention towards eventual reasons for biological treatment failure or withdrawal. The majority of data is found in secondary analyses of clinical trials and in retrospective cohorts. Most information is available about tumor necrosis factor (TNF) blockers. Older patients seem to have a less robust response to anti-TNF agents than a younger population, but drug survival that may considered a proxy for efficacy does not seem to be influenced by age. Despite an overall rate of adverse effects comparable to that in younger patients, elderly RA patients are at higher risk of serious infections. Other biologics appear to have an efficacy similar to anti-TNF agents, also in the elderly RA patients. Again, the drug survival rates for tocilizumab, rituximab and abatacept resemble those in young RA patients with good general tolerability and safety profiles. The cardiovascular risk and the risk of cancer, increased in RA patents and in the elderly patients, do not appear to be strongly influenced by biologicals. Key points-Biological drugs targeting specific cytokines or immune cell populations are an important part of the management strategy for rheumatoid arthritis patients, including the elderly. 3-Overall safety and tolerability in the elderly patients is very good and age should not be a critical factor to decide against biological drug use.-The drug survival rate of biologicals in the elderly RA patients is comparable to that in the young RA population.-Co-morbidities and risk of infection are important variables to assess when considering a biological drug in the elderly.-More data and specific studies are required to better position biological drug use in this particular population as current studies provide a low level of evidence. Data in patients above 75 years are still largely missing. Moreover, the group of elderly patients that were included in clinical trials may be influenced by selection bias at inclusion and not be fully representative for infections risks and other comorbidities.4

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Section: Abataceptsupporting

confidence: 64%

Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Older Rheumatoid Arthritis Patients: Staying the Distance

Ishchenko

Lories

2016

Drugs Aging

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“…In an abstract from the 2012 ACR Annual Scientific Meeting and in a recent study by Ribeiro et al, abatacept (ABA) seemed to compromise the immune response to influenza vaccination in RA patients (35,36). In an abstract from the 2007 ACR Annual Scientific Meeting, tocilizumab (TCZ) did not affect the antibody response to pneumococcal vaccination in patients with RA (37).…”

Section: Discussionmentioning

confidence: 99%

Effect of Methotrexate, Anti–Tumor Necrosis Factor α, and Rituximab on the Immune Response to Influenza and Pneumococcal Vaccines in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Hua

Barnetche

Combe

et al. 2014

Arthritis Care & Research

271

167

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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 biologic agents. The efficacy of vaccination, assessed by the response rate based on increased antibody titers before and 3-6 weeks after vaccination, was extracted by one investigator and verified by another. Results. In total, 12 studies were included. RA patients mainly received MTX, anti-tumor necrosis factor ␣ (anti-TNF␣), or rituximab (RTX). Influenza vaccination response was reduced for RTX (43 patients; pooled odds ratio [OR

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“…Seroprotection (antibody titers ≥ 1:40) was significantly reduced in the abatacepttreated RA patients (9%) compared to RA patients on methotrexate (58%) and healthy controls (69%) [40]. The factor increase in GMTs was lower in abatacept-treated RA patients (1.8) compared to the methotrexate-treated RA patients (8.7) and healthy controls (11.5) [40].…”

Section: Abataceptmentioning

confidence: 91%

“…Antibody titers against non-adjuvanted monovalent pandemic 2009 influenza A/H1N1 vaccine were evaluated by hemagglutination inhibition (HI) assay in 11 RA patients treated with abatacept and concomitant non-biologic DMARDs compared to 33 age-matched RA patients on methotrexate and 55 healthy controls 21 days after vaccination [40]. Seroprotection (antibody titers ≥ 1:40) was significantly reduced in the abatacepttreated RA patients (9%) compared to RA patients on methotrexate (58%) and healthy controls (69%) [40]. The factor increase in GMTs was lower in abatacept-treated RA patients (1.8) compared to the methotrexate-treated RA patients (8.7) and healthy controls (11.5) [40].…”

Section: Abataceptmentioning

confidence: 99%

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

Prelog¹

2013

J Clin Cell Immunol

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Abatacept and reduced immune response to pandemic 2009 influenza A/H1N1 vaccination in patients with rheumatoid arthritis

Cited by 101 publications

References 16 publications

Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Older Rheumatoid Arthritis Patients: Staying the Distance

Safety and Efficacy of Biological Disease-Modifying Antirheumatic Drugs in Older Rheumatoid Arthritis Patients: Staying the Distance

Effect of Methotrexate, Anti–Tumor Necrosis Factor α, and Rituximab on the Immune Response to Influenza and Pneumococcal Vaccines in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

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