Impact of tocilizumab therapy on antibody response to influenza vaccine in patients with rheumatoid arthritis
Impact of tocilizumab therapy on antibody response to influenza vaccine in patients with rheumatoid arthritis
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DOI：
10.1136/annrheumdis-2012-201950
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发表时间：
2012-12-01
影响因子：
27.4
通讯作者：
Oishi, Kazunori
中科院分区：
文献类型：
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作者：
Mori, Shunsuke;Ueki, Yukitaka;Oishi, Kazunori
目的 我们评估了托珠单抗 (TCZ)（一种人源化单克隆抗白介素 6 受体抗体）对类风湿性关节炎 (RA) 患者流感疫苗接种后抗体反应的影响。 方法 共有 194 名 RA 患者接受了非活性三价流感疫苗接种（A/H1N1、A/H3N2 和 B/B1 株）。所有患者均分为TCZ组（n=62）、TCZ+甲氨蝶呤（MTX）组（n=49）、MTX组（n=65）和RA对照组（n=18）。使用血凝抑制试验在接种前和接种后4-6周测量抗体滴度。结果对于A/H1N1和A/H3N2毒株，TCZ和TCZ+MTX组实现了9.9-14.5倍的增加，接种后血清保护率大于70%，血清反应率大于40%。对于 B/B1 菌株，在这些治疗组中，血清反应率约为 30%，但倍数增加和血清保护率分别为 5.0-5.4 和大于 70%。 MTX 对疫苗接种效果有负面影响，但 MTX 组仍表现出足够的保护反应。未观察到严重不良反应或 RA 发作。结论 TCZ 不会妨碍 RA 患者对流感疫苗的抗体反应。流感疫苗接种被认为可以有效保护接受 TCZ 治疗（联合或不联合 MTX）的 RA 患者。
Objectives We assessed the influence of tocilizumab (TCZ), a humanised monoclonal anti-interleukin-6 receptor antibody, on antibody response following influenza vaccination in patients with rheumatoid arthritis (RA).Methods A total of 194 RA patients received inactive trivalent influenza vaccination (A/H1N1, A/H3N2 and B/B1 strains). All patients were classified into the TCZ (n=62), TCZ+methotrexate (MTX) (n=49), MTX (n=65) and RA control (n=18) groups. Antibody titres were measured before and 4-6 weeks after vaccination using the haemagglutination inhibitory assay.Results For the A/H1N1 and A/H3N2 strains, the TCZ and TCZ+MTX groups achieved fold increases of 9.9-14.5, postvaccination seroprotection rates greater than 70% and seroresponse rates greater than 40%. For the B/B1 strain, seroresponse rates were approximately 30%, but fold increases and seroprotection rates were 5.0-5.4 and greater than 70%, respectively, in these treatment groups. MTX had a negative impact on vaccination efficacy, but adequate responses for protection were nevertheless demonstrated in the MTX group. Neither severe adverse effects nor RA flares were observed.Conclusions TCZ does not hamper antibody response to influenza vaccine in RA patients. Influenza vaccination is considered effective in protecting RA patients receiving TCZ therapy with or without MTX.