Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial
Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial
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DOI：
10.1136/annrheumdis-2018-213222
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发表时间：
2018-06-01
影响因子：
27.4
通讯作者：
Lee, Eun Bong
中科院分区：
文献类型：
--
作者：
Park, Jin Kyun;Lee, Yun Jong;Lee, Eun Bong
目的探讨甲氨蝶呤（MTX）疫苗接种后停药2周是否能提高类风湿关节炎（RA）患者季节性流感疫苗接种的效果。主要结局是满意的疫苗应答频率，定义为接种4种疫苗株中的2种后4周时血凝抑制（HI）抗体滴度增加≥ 4倍。次要终点包括血清保护（即HI滴度1：40）率，抗体滴度的倍数变化。结果修改后的意向治疗人群包括156例MTX继续组和160例MTX暂停组患者。停药组获得满意疫苗应答的患者多于继续用药组（75.5%比54.5%，p
Objective To determine whether a 2-week methotrexate (MTX) discontinuation after vaccination improves the efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis (RA).Methods In this prospective randomised parallel-group multicentre study, patients with RA on stable dose of MTX were randomly assigned at a ratio of 1:1 to continue MTX or to hold MTX for 2weeks after 2016-2017 quadrivalent seasonal influenza vaccine containing H1N1, H3N2, B-Yamagata and B-Victoria. The primary outcome was frequency of satisfactory vaccine response, defined as greater than or equal to fourfold increase of haemagglutination inhibition (HI) antibody titre at 4 weeks after vaccination against 2 of four vaccine strains. Secondary endpoints included seroprotection (ie, HI titre 1:40) rate, fold change in antibody titres.Results The modified intention-to-treat population included 156 patients in the MTX-continue group and 160 patients in the MTX-hold group. More patients in MTX-hold group achieved satisfactory vaccine response than the MTX-continue group (75.5% vs 54.5%, p