Protective effect of A/H1N1 vaccination in immune-mediated disease--a prospectively controlled vaccination study

Abstract

The results show that vaccination response is a function of disease type, intensity and character of medication and age. A single injection of adjuvanted influenza vaccine is sufficient to protect a high percentage of patients. Therefore, differential vaccination recommendations might in the future reduce costs and increase vaccination acceptance.

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

“…Only 25% of patients on rituximab showed a HI ≥ 1:40 at 3 weeks, 6 weeks and 6 months after vaccination, but 45%, 35% and 20% of patients with abatacept and 98%, 95% and 75% in healthy controls [46]. In that study a significant influence of disease type, intensity, type of medication and age were described [46].…”

“…However, there was a significant lower GMT response to adjuvanted H1N1 influenza vaccination in 5 RA patients with rituximab and 10 RA patients with abatacept compared to 40 healthy controls [46]. Only 25% of patients on rituximab showed a HI ≥ 1:40 at 3 weeks, 6 weeks and 6 months after vaccination, but 45%, 35% and 20% of patients with abatacept and 98%, 95% and 75% in healthy controls [46].…”

“…Regarding safety aspects, none of the studies [41][42][43][44][45][46] showed a significant increase of flares, inflammatory parameters or worsening of the disease.…”

Vaccinations for rheumatoid arthritis

“…A recent study, in 2012, involving RA patients receiving tocilizumab, methotrexate (MTX) or the combination of the two suggest that there was no decreased effects of TCZ, and post-vaccination GMTs increased significantly for all strains of the influenza vaccine [19]. Abatacept, on the other hand, has been shown to significantly reduce the humoral response to pandemic 2009 influenza A/H1N1 vaccine in RA patients compared to patients with RA on methotrexate and healthy controls, although this study did not evaluate tri-or quadrivalent vaccine [12,20]. Rituximab severely reduces the responsiveness of the influenza vaccine in patients with RA as shown in several studies, and, not surprisingly, this reduction in response is dependent upon the timing of the vaccine in relation to rituximab administration [21][22][23][24].…”

Vaccination in Rheumatology: Current Aspects

“…Применение абатацепта (АБЦ) в виде внутривенных инфузий у больных РА вело к значимому снижению постиммунизационного ответа на вакцину против эпидемического (H1N1) гриппа по срав-нению с пациентами, получавшими МТ, и контролем [35,36]. С другой стороны, при назначении АБЦ в форме для подкожного введения частота серопротекции по отноше-нию к двум из трех антигенов сезонной противогриппоз-ной вакцины составила 82,1% [37], что полностью соответ-ствовало вышеуказанным требованиям Европейского ко-митета.…”