Vaccination against influenza in rheumatoid arthritis:: the effect of disease modifying drugs, including TNFα blockers
Vaccination against influenza in rheumatoid arthritis:: the effect of disease modifying drugs, including TNFα blockers
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DOI：
10.1136/ard.2005.036434
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发表时间：
2006-02-01
影响因子：
27.4
通讯作者：
Elkayam, O
中科院分区：
文献类型：
--
作者：
Fomin, I;Caspi, D;Elkayam, O
目的：评估类风湿关节炎患者接种流感病毒疫苗的有效性和安全性，特别强调疾病缓解抗风湿药物（DMARD）的作用，包括肿瘤坏死因子α（TNF α）阻断剂。82名类风湿患者和30名健康对照者接种裂解病毒灭活疫苗，每剂含有15 mg血凝素（HA）的B/Hong Kong/330/2001（HK）、A/Panama/2007/99（PAN）和A/New Caledonian/20/99（NC）。在接种当天和6周后，通过压痛和肿胀关节计数、晨僵、疼痛评估、健康评估问卷、ESR和C反应蛋白评估疾病活动性。通过标准WHO程序检测血凝抑制（HI）抗体。应答定义为接种疫苗后6周HI抗体升高4倍或更多，或抗体基线水平非保护性的患者血清转化（< 1/40）。几何平均滴度（GMT）进行计算，以评估整个group.Results免疫：接种后6周，在两组中观察到每个抗原的GMT显着增加，这是在健康组HK（p = 0.004）较高。类风湿患者中应答者的百分比低于健康对照组（对HK具有显著性）。泼尼松或任何DMARD（包括甲氨蝶呤、英夫利西单抗和依那西普）均不影响应答者的百分比。疾病活动指数保持不变。结论：流感病毒疫苗产生了良好的体液反应类风湿患者，虽然低于健康对照。泼尼松或DMARD的使用不影响疗效。
Objective: To assess the efficacy and safety of vaccination against influenza virus in patients with rheumatoid arthritis, with special emphasis on the effect of disease modifying antirheumatic drugs (DMARDs), including tumour necrosis factor alpha (TNF alpha) blockers.Methods: 82 rheumatoid patients and 30 healthy controls were vaccinated with a split-virion inactivated vaccine containing 15 mg haemagglutinin (HA) per dose of each of B/Hong Kong/330/2001 (HK), A/Panama/2007/99 ( PAN), and A/New Caledonian/20/99 (NC). Disease activity was assessed by tender and swollen joint count, morning stiffness, evaluation of pain, Health Assessment Questionnaire, ESR, and C reactive protein on the day of vaccination and six weeks later. Haemagglutination inhibiting ( HI) antibodies were tested by a standard WHO procedure. Response was defined as a fourfold or more rise in HI antibodies six weeks after vaccination, or seroconversion in patients with a non-protective baseline level of antibodies (< 1/40). Geometric mean titres (GMT) were calculated to assess the immunity of the whole group.Results: Six weeks after vaccination, a significant increase in GMT for each antigen was observed in both groups, this being higher in the healthy group for HK (p = 0.004). The percentage of responders was lower in rheumatoid patients than healthy controls (significant for HK). The percentage of responders was not affected by prednisone or any DMARD, including methotrexate, infliximab, and etanercept. Indices of disease activity remained unchanged.Conclusions: Influenza virus vaccine generated a good humoral response in rheumatoid patients, although lower than in healthy controls. The response was not affected by the use of prednisone or DMARDs.