The cellular immune response to influenza vaccination is preserved in rheumatoid arthritis patients treated with rituximab

Arad, Uri; Tzadok, Sasi; Sharon, Amir; Mandelboim, Michal; Mendelson, Ella; Wigler, Irena; Sarbagil-Maman, Hagit; Paran, Daphna; Caspi, Dan; Elkayam, Ori

doi:10.1016/j.vaccine.2010.12.072

Cited by 116 publications

(117 citation statements)

References 29 publications

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“…Across the 2 years during which patients received on-study vaccinations, 24 of 29 patients without preexisting antibody titers > 1:10 for ≥ 1 antigen were able to mount a response to that antigen. The quantitatively reduced specific antibody response to the 2008-9 influenza vaccine is consistent with the impaired humoral response to influenza vaccination in patients with rheumatoid arthritis receiving rituximab, a mono clonal antibody-targeting B cell CD20 protein 16,17,18,19 .…”

Section: Discussionsupporting

confidence: 56%

Effect of Belimumab on Vaccine Antigen Antibodies to Influenza, Pneumococcal, and Tetanus Vaccines in Patients with Systemic Lupus Erythematosus in the BLISS-76 Trial

Chatham¹,

Wallace²,

Stohl³

et al. 2012

J Rheumatol

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Objective.In patients with systemic lupus erythematosus (SLE), evidence suggests that most vaccines (except live-virus vaccines) are safe, although antibody response may be reduced. This substudy from the phase III, randomized, double-blind, placebo-controlled BLISS-76 trial evaluated the effects of belimumab on preexisting antibody levels against pneumococcal, tetanus, and influenza antigens in patients with SLE.Methods.In BLISS-76, patients with autoantibody-positive, active SLE were treated with placebo or belimumab 1 or 10 mg/kg every 2 weeks for 28 days and every 28 days thereafter, plus standard SLE therapy, for 76 weeks. This analysis included a subset of patients who had received pneumococcal or tetanus vaccine within 5 years or influenza vaccine within 1 year of study participation. Antibodies to vaccine antigens were tested at baseline and Week 52, and percentage changes in antibody levels from baseline and proportions of patients maintaining levels at Week 52 were assessed. Antibody titers were also assessed in a small number of patients vaccinated during the study.Results.Consistent with preservation of the memory B cell compartment with belimumab treatment, the proportions of patients maintaining antibody responses to pneumococcal, tetanus, and influenza antigens were not reduced. In a small group receiving influenza vaccine on study, antibody responses were frequently lower with belimumab, although titer levels were > 1:10 in all patients treated with 10 mg/kg and in the majority treated with 1 mg/kg.Conclusion.Treatment with belimumab did not affect the ability of patients with SLE to maintain antibody titers to previous pneumococcal, tetanus, and influenza immunizations. [ClinicalTrials.gov registration number NCT 00410384]

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Section: Discussionsupporting

confidence: 56%

Effect of Belimumab on Vaccine Antigen Antibodies to Influenza, Pneumococcal, and Tetanus Vaccines in Patients with Systemic Lupus Erythematosus in the BLISS-76 Trial

Chatham¹,

Wallace²,

Stohl³

et al. 2012

J Rheumatol

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“…In the included studies concerning RTX, the delay between vaccination and infusion varied, and in the Bingham et al study, the immune response was decreased even with infusion up to 7 months earlier (26). In the study by Arad et al, the response rate was higher for RTX-treated patients vaccinated later (Ͼ5 months) after RTX administration than those vaccinated earlier after treatment (22). In contrast, the study by Oren et al found no correlation between humoral response and the time interval since receiving RTX (21).…”

Section: Discussionmentioning

confidence: 99%

“…Two studies assessed the humoral response to influenza vaccine with (experimental group) and without (control group) RTX treatment (21,22). The response rate was reduced with RTX, but the pooled OR was not significant for the H1N1 strain (Figure 2).…”

Section: Influenza Vaccinationmentioning

confidence: 99%

Effect of Methotrexate, Anti–Tumor Necrosis Factor α, and Rituximab on the Immune Response to Influenza and Pneumococcal Vaccines in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Hua

Barnetche

Combe

et al. 2014

Arthritis Care & Research

272

167

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Objective. To assess the current literature on the impact of rheumatoid arthritis (RA) treatments on the humoral response to pneumococcal and influenza vaccines. Methods. We systematically searched the literature for studies evaluating the immune response to vaccines in RA patients receiving methotrexate (MTX) and/or biologic agents. The efficacy of vaccination, assessed by the response rate based on increased antibody titers before and 3-6 weeks after vaccination, was extracted by one investigator and verified by another. Results. In total, 12 studies were included. RA patients mainly received MTX, anti-tumor necrosis factor ␣ (anti-TNF␣), or rituximab (RTX). Influenza vaccination response was reduced for RTX (43 patients; pooled odds ratio [OR

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“…Influenza-specific IgM-secreting B cells were significantly reduced in the post-rituximab group compared to the pre-rituximab group and to the control group [44]. Irrespective of rituximab treatment, the number of influenza-specific IgG-and IgA-producing cells was similar between the groups [44].…”

Section: Rituximabmentioning

confidence: 84%

“…Influenza-vaccine specific cellular responses were evaluated in RA patients at day 6 after vaccination who had rituximab treatment 6 months ago (post-rituximab group) and in RA patients 6 days before rituximab administration (pre-rituximab group) compared to an RA patient control group, who was not exposed to rituximab [44]. Influenza-specific IgM-secreting B cells were significantly reduced in the post-rituximab group compared to the pre-rituximab group and to the control group [44].…”

Section: Rituximabmentioning

confidence: 99%

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

Prelog¹

2013

J Clin Cell Immunol

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The cellular immune response to influenza vaccination is preserved in rheumatoid arthritis patients treated with rituximab

Cited by 116 publications

References 29 publications

Effect of Belimumab on Vaccine Antigen Antibodies to Influenza, Pneumococcal, and Tetanus Vaccines in Patients with Systemic Lupus Erythematosus in the BLISS-76 Trial

Effect of Belimumab on Vaccine Antigen Antibodies to Influenza, Pneumococcal, and Tetanus Vaccines in Patients with Systemic Lupus Erythematosus in the BLISS-76 Trial

Effect of Methotrexate, Anti–Tumor Necrosis Factor α, and Rituximab on the Immune Response to Influenza and Pneumococcal Vaccines in Patients With Rheumatoid Arthritis: A Systematic Review and Meta‐Analysis

Vaccination in Patients with Rheumatoid Arthritis Receiving Immunotherapies

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