Immunogenicity and impact on disease activity of influenza and pneumococcal vaccines in systemic lupus erythematosus: a systematic literature review and meta-analysis

Pugès, Mathilde; Biscay, P.; Barnetche, Thomas; Truchetet, Marie-Élise; Richez, Christophe; Sénéschal, Julien; Gensous, Noémie; Lazaro, Estibaliz; Duffau, Pierre

doi:10.1093/rheumatology/kew211

Cited by 63 publications

(45 citation statements)

References 22 publications

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“…After the screening of the title and/or abstract, 8,850 items were discarded. The fulltext of 60 investigations was assessed and 14 texts were excluded with reasons (as reported in Table 2) (21,26,27,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Finally, 22 articles were included (4 studies had overlapping populations) in the present systematic reviews.…”

Section: Resultsmentioning

confidence: 99%

Immunogenicity, safety and tolerability of anti-pneumococcal vaccination in systemic lupus erythematosus patients: An evidence-informed and PRISMA compliant systematic review and meta-analysis

Adawi

Bragazzi

McGonagle

et al. 2019

Autoimmunity Reviews

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Section: Resultsmentioning

confidence: 99%

Immunogenicity, safety and tolerability of anti-pneumococcal vaccination in systemic lupus erythematosus patients: An evidence-informed and PRISMA compliant systematic review and meta-analysis

Adawi

Bragazzi

McGonagle

et al. 2019

Autoimmunity Reviews

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“…Имеются многочисленные данные, свидетельствующие об отсутствии значимого негативного влияния вакцинации на течение основного РЗ. При иммунизации ППВ-23 больных СКВ большинство исследователей отмечают отсутствие серьезных неблагоприятных реакций, а также значимых изменений активности СКВ по шкале SLEDAI [19,20]. Следовательно, вакцинация ППВ-23 не является триггером ни аутоиммунных воспалительных заболеваний, ни их обострений [21].…”

Section: Discussionunclassified

Investigation of Immunogenicity and Safety of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients With Systemic Lupus Erythematosus

Тарасова¹,

Белов²,

Буханова³

et al. 2018

rsp

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Objective: to investigate the safety and immunogenicity of 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE). Subjects and methods. The investigation enrolled 30 patients with a reliable diagnosis of SLE; of them there were 27 women and 3 men at the age of 19 to 62 years. The disease duration ranged from 9 months to 20 years. At the time of inclusion in the investigation, the disease activity was high in 2 patients, moderate in 3, and low in 20; five patients were in remission. During a year before vaccination, pneumonia was detected in 5 (16.7%) of the 30 patients; there were a total of 18 episodes of various respiratory and ENT infections. The patients were examined at baseline and at 1, 3 and 12 months after vaccination. Standard clinical and laboratory studies and a detailed blood immunological analysis were carried out at visits. The levels of IgG antibodies to capsular polysaccharide pneumococcus were determined during each visit. Twenty-nine patients received glucocorticoids (GCs) at a dose of 5–30 mg/day; 24 – hydroxychloroquine; 14 – cytostatics (CS); 10 – biological agents (BAs) (5 – rituximab, 5 – belimumab). A single dose of 0.5 ml of PPV-23 (Pneumo 23, Aventis) was subcutaneously injected into the upper outer arm. Vaccination was done during the ongoing therapy with GC/CS and belimumab, as well as at least 1 month before the first (next) administration and/or 4.5–5 months after the last rituximab infusion. Results and discussion. 60% of patients were observed to have mild and moderate standard local vaccine reactions; 1 (3.3%) patient had a local hyperergic reaction eliminated within 7 days of the local application of antihistamines and GCs. During the follow-up, there was no SLE exacerbation significantly associated with the vaccination performed. No new autoimmune phenomena were found in any of the cases. A year after vaccination, a significant (2-fold or more) increase in anti-pneumococcal antibody levels remained in 19 (63.3%) patients (respondents); 36.7% of patients were nonrespondents. Among the patients who received a BA, the non-responders were significantly more than among those who did not take the drug (7 (70%) and 4 (20%), respectively) (p = 0.01). When treated with rituximab and belimumab, the number of non-respondents was comparable (4 and 3, respectively). The immunogenicity of PPV-23 was independent of the degree of SLE activity: the vaccine response was absent in 1 out of the 5 patients with high (n = 2) and medium (n = 3) SLE activities, as well as in 10 out of the 25 patients with low disease activity and remission. There was no development of considerable adverse reactions after vaccination in patients with high and medium SLE activity. The overall clinical efficiency of vaccination was 93.3%. Conclusion. Thus, PPV-23 shows a good tolerability and a sufficient immunogenicity in patients with SLE. There is a need for further investigations conducted in large samples of patients during long-term follow-ups in order to more fully evaluate the clinical efficacy, tolerability, and immunogenicity of PPV-23.

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“…Despite these concerns, immunization of patients with AIRD has been shown to be safe in many studies. [73][74][75][76][77] Immunizations are strongly recommended for persons with AIRD by IDSA, 1 Canadian National Vaccination Guidelines for Patients with Immune-Mediated Disorders on Immunosuppressive Therapies, 78 the American College of Rheumatology, 6 and the European League Against Rheumatism. 79 Immunosuppressive therapy impacts vaccine immunogenicity and efficacy; and the magnitude of this impact depends on both vaccine type and medication.…”

Section: Autoimmune Inflammatory Rheumatic Diseases and Immunosuppresmentioning

confidence: 99%

Immunization Strategies to Span the Spectrum of Immunocompromised Adults

Whitaker

2020

Mayo Clinic Proceedings

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The Advisory Committee on Immunization Practices to the US Centers for Disease Control and Prevention provides annual recommendations for routine adult immunizations. Many recommendations consider patient factors such as age, medical conditions, and medications that increase an individual's risk for infection with a vaccine-preventable disease. These factors, particularly those that lead to immunocompromise, may also alter the risk-benefit ratio for live vaccines, and/or lead to decreased vaccine immunogenicity and effectiveness. The provider may need to consider alternative vaccination strategies, including higher antigen dose vaccines, adjuvanted vaccines, avoidance of live vaccines, and careful timing of vaccination to optimize safety and effectiveness in immunocompromised populations. This thematic review discusses general principles regarding immunization of adults across the spectrum of immunocompromise, examines current guidelines and studies that support them, and outlines future research needs.

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Immunogenicity and impact on disease activity of influenza and pneumococcal vaccines in systemic lupus erythematosus: a systematic literature review and meta-analysis

Cited by 63 publications

References 22 publications

Immunogenicity, safety and tolerability of anti-pneumococcal vaccination in systemic lupus erythematosus patients: An evidence-informed and PRISMA compliant systematic review and meta-analysis

Immunogenicity, safety and tolerability of anti-pneumococcal vaccination in systemic lupus erythematosus patients: An evidence-informed and PRISMA compliant systematic review and meta-analysis

Investigation of Immunogenicity and Safety of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients With Systemic Lupus Erythematosus

Immunization Strategies to Span the Spectrum of Immunocompromised Adults

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