Reevaluation of antibody titers 1 year after influenza vaccination in patients with rheumatoid arthritis receiving TNF blockers

Nii, Tokiko; Nanki, Toshihiro; Komano, Yukiko; Harigai, Masayoshi; Kohsaka, Hitoshi; Hirose, Wataru; Nagasaka, Kenji; Sakurai, Tadakazu; Miyasaka, Nobuyuki

doi:10.3109/s10165-008-0135-z

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…Hydroxychloroquine does not influence the development of an adequate immune response to influenza vaccination 47 64 66. The same holds true for the use of TNFα-blocking agents in the majority of studies,11 13 20 41 80 including two meta-analyses in RA 75 77. Another meta-analysis reported a lower seroprotection, but not seroconversion rate in patients with RA on anti-TNF α, only for the H1N1 influenza strain 42.…”

Section: Resultsmentioning

confidence: 93%

“…Most studies on influenza vaccination in patients with AIIRD, however, address immunogenicity, mainly by assessing the development of a protective level of antibodies (titre value ≥40, as measured by the haemagglutination inhibition assay). For RA, most of these studies report similar responses in patients and HCs 7 9–15 20 38–41. A meta-analysis including a total of 886 patients with RA and 685 controls concluded that 60%, 68% and 61% of patients with RA reached seroprotective antibody levels following influenza vaccination for the H1N1, H3N2 and B strain, respectively.…”

Section: Resultsmentioning

confidence: 98%

“…Up to the previous recommendations, one study addressed the issue of efficacy of influenza vaccination in patients with AIIRD 6. Immunogenicity of the vaccine had been evaluated in 26 studies, mainly including patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and granulomatosis with polyangiitis (GPA) 7–32. Most of these studies demonstrated similar rates of immunogenicity among patients and healthy controls (HC), except for the studies in patients treated with rituximab, whose responses were severely impaired 12 14 33…”

Section: Resultsmentioning

confidence: 99%

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Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

et al. 2019

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AimTo present a systematic literature review (SLR) on efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD), aiming to provide a basis for updating the EULAR evidence-based recommendations.MethodsAn SLR was performed according to the standard operating procedures for EULAR-endorsed recommendations. Outcome was determined by efficacy, immunogenicity and safety of vaccination in adult patients with AIIRD, including those receiving immunomodulating therapy. Furthermore, a search was performed on the effect of vaccinating household members of patients with AIIRD on the occurrence of vaccine-preventable infections in patients and their household members (including newborns). The literature search was performed using Medline, Embase and the Cochrane Library (October 2009 to August 2018).ResultsWhile most investigated vaccines were efficacious and/or immunogenic in patients with AIIRD, some were less efficacious than in healthy control subjects, and/or in patients receiving immunosuppressive agents. Adverse events of vaccination were generally mild and the rates were comparable to those in healthy persons. Vaccination did not seem to lead to an increase in activity of the underlying AIIRD, but insufficient power of most studies precluded arriving at definite conclusions. The number of studies investigating clinical efficacy of vaccination is still limited. No studies on the effect of vaccinating household members of patients with AIIRD were retrieved.ConclusionEvidence on efficacy, immunogenicity and safety of vaccination in patients with AIIRD was systematically reviewed to provide a basis for updated recommendations.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

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Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

et al. 2019

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“…Most studies have focused on immunogenicity as surrogate outcome for efficacy. Influenza vaccination has been shown to be immunogenic in patients with RA, SLE, ANCA-associated vasculitis (AAV), SSc, and PsA, treated with all classes of DMARDs,33 59 64–98 except for rituximab 37 41 43 99 100. Temporary discontinuation of MTX was shown to improve immunogenicity of seasonal influenza vaccination in patients with RA, with the best results when MTX was suspended for 2 weeks before and 2 weeks after vaccination 101 102.…”

Section: Resultsmentioning

confidence: 99%

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

et al. 2019

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To update the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) published in 2011. Four systematic literature reviews were performed regarding the incidence/prevalence of vaccine-preventable infections among patients with AIIRD; efficacy, immunogenicity and safety of vaccines; effect of anti-rheumatic drugs on the response to vaccines; effect of vaccination of household of AIIRDs patients. Subsequently, recommendations were formulated based on the evidence and expert opinion. The updated recommendations comprise six overarching principles and nine recommendations. The former address the need for an annual vaccination status assessment, shared decision-making and timing of vaccination, favouring vaccination during quiescent disease, preferably prior to the initiation of immunosuppression. Non-live vaccines can be safely provided to AIIRD patients regardless of underlying therapy, whereas live-attenuated vaccines may be considered with caution. Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with AIIRD. Tetanus toxoid and human papilloma virus vaccination should be provided to AIIRD patients as recommended for the general population. Hepatitis A, hepatitis B and herpes zoster vaccination should be administered to AIIRD patients at risk. Immunocompetent household members of patients with AIIRD should receive vaccines according to national guidelines, except for the oral poliomyelitis vaccine. Live-attenuated vaccines should be avoided during the first 6 months of life in newborns of mothers treated with biologics during the second half of pregnancy. These 2019 EULAR recommendations provide an up-to-date guidance on the management of vaccinations in patients with AIIRD.

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“…The immunogenicity of patients with rheumatoid arthritis is similar to that of healthy individuals, and immunogenicity can be maintained even when conventional synthetic DMARDs (csDMARDs) or anti-TNF drugs [34,[51][52][53][54][55][56][57][58][59][60][61] are administered. It has often been reported that the immunogenicity of patients with lupus is slightly decreased, and many studies reported no significant differences in immunogenicity between patients with lupus and healthy individuals [18,20,57,[62][63][64][65][66][67][68][69][70].…”

Section: ) Effects and Efficacy Of Vaccinementioning

confidence: 99%

The Practice Guideline for Vaccinating Korean Patients With Autoimmune Inflammatory Rheumatic Disease

et al. 2020

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To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and the Korean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measles-mumps-rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.

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Reevaluation of antibody titers 1 year after influenza vaccination in patients with rheumatoid arthritis receiving TNF blockers

Cited by 10 publications

References 6 publications

Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations

2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

The Practice Guideline for Vaccinating Korean Patients With Autoimmune Inflammatory Rheumatic Disease

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