The Effect of tumor necrosis factor blockade on the response to pneumococcal vaccination in patients with rheumatoid arthritis and ankylosing spondylitis

Elkayam, Ori; Caspi, Dan; Reitblatt, Tatiana; Charboneau, Darlene; Rubins, Jeffrey B.

doi:10.1053/j.semarthrit.2003.10.003

Cited by 162 publications

(79 citation statements)

References 23 publications

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“…When vaccinated against meningococcal infection, children with JIA also demonstrated the ability to synthesize protective antibodies, though their immune response was less intense than that in healthy children. Moreover, the patients with anti-TNF-α therapy combined with methothrexate appeared to have marked suppression of immune response compared to the cases with methothrexate administration alone [15,20].…”

Section: сLinical Medicinementioning

confidence: 91%

In vitro Cytokine Synthesis by Lymphocytes in Children in Juvenile Idiopathic Arthritis Remission Against the Background of Genetically Engineered Biologic Drug Therapy

Zakirov¹,

Акулова²,

Filyanskaya³

et al. 2016

Sovrem Tehnol Med

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Section: сLinical Medicinementioning

confidence: 91%

In vitro Cytokine Synthesis by Lymphocytes in Children in Juvenile Idiopathic Arthritis Remission Against the Background of Genetically Engineered Biologic Drug Therapy

Zakirov¹,

Акулова²,

Filyanskaya³

et al. 2016

Sovrem Tehnol Med

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“…The antibody response to influenza vaccination in patients treated with anti-TNF is modestly impaired, but the proportion of patients who achieve a protective titre is not significantly diminished by the use of anti-TNF therapies. 38 Pneumococcal vaccination seems to be less effective when on anti-TNF therapy -significantly fewer patients respond to the vaccine. 39 If possible, pneumococcal vaccine should be given before starting anti-TNF drugs, especially in the elderly, but the timing is problematic.…”

Section: Opportunistic Infectionsmentioning

confidence: 99%

Inflammatory Bowel Disease in Older People

Grimpen¹,

Pavli

2008

Pharmacy Practice and Res

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Inflammatory bowel disease (IBD) can affect patients of all ages. The majority of patients are diagnosed in the second or third decade of life, but a minority develop the disease at an advanced age. Diagnosis can be delayed due to the preconception that IBD mainly affects young people, and the broader spectrum of differential diagnoses in the elderly. Management and treatment options are similar to those in younger patients but adverse reactions and drug interactions may be of greater significance in the elderly. Precluding treatment with anti-tumour necrosis factor drugs on grounds of previous infection with tuberculosis or viral hepatitis, comorbidities or previous malignancy -factors often found with advanced age -can make treatment challenging. The increased risk of bowel cancer in IBD warrants regular screening, especially in the elderly as their absolute risk of cancer is higher.

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“…The role of these serotypes and their follow up are essential for development of the new generation of conjugate vaccines (6). and elderly patients (11,12,13,14). However, the use of immunosuppressive drugs, such as anti-TNF biologics may mildly-moderately impair the host response to various vaccines against pneumococcal, influenza and other infections (15,16).…”

Section: Introductionmentioning

confidence: 99%

“…Kapatenovic et al (16,9,9,12) investigated the 7-valent conjugated pneumococcal vaccine in adult RA patients treated with ETA. These studies have shown protective immune response using PCV7 vaccine.…”

Section: Introductionmentioning

confidence: 99%

FRI0292 Efficacy of A Conjugated Pneumococcus Vaccine in Rheumatoid Arthritis Patients Treated with Etanercept

Rákóczi¹,

Perge

Végh

et al. 2014

Annals of the Rheumatic Diseases

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Objectives: To prospectively evaluate the immunogenicity of a 13-valent conjugated pneumococcal vaccine (PCV13) in rheumatoid arthritis (RA) patients undergoing etanercept therapy. Methods: Twenty-two RA patients treated with etanercept (ETA) in combination with methotrexate (MTX) (n=15) or monotherapy (n=7) for at least one year were included. Altogether 24 osteoarthritis patients not receiving biological or MTX therapy, treating only NSAIDs or analgesics served as controls. All subjects were vaccinated with a single dose (0.5 ml) of the PCV13. Pneumococcal antibody levels at baseline, 4 and 8 weeks were assessed by a VaccZymeTM Anti-PCP IgG Enzyme Immunoassay Kit. Based on recommendations of the American Academy of Allergy, Asthma & Immunology, an at least twofold increase in antibody level, as the protective antibody response (pAR) was an indicator of responsiveness (i.e., ratio of postvaccination and prevaccination antibody levels). The antibody levels and their ratios were analysed in a variety of different ways, vaccine safety parameters (fever, infections, changes in regular antirheumatic treatments) were assessed at baseline, 4 and 8 weeks after vaccination. Results: Four weeks after vaccination, the anti-pneumococcal antibody levels significantly increased in both groups. At week 8, antibody levels somewhat decreased in both groups, however, still remained significantly higher compared to baseline. Compared with postvaccination levels at 4 and 8 weeks between two groups, the mean protective antibody levels were higher in control group (1st month p=0.016; 2nd month: p=0.039). Possible predictors of pAR were analysed by logistic regression model. In RA, increases of antibody levels at week 8 compared to baseline exerted a negative correlation with age, (Spearman's R=-0,431; p=0.045). There were no clinically significant side effects or reaction after administration of vaccine observed in any of these patients after the 2-month follow-up period, all patients medical condition were stable. Conclusions: In RA patients treated with ETA, vaccination with PCV13 is effective and safe, resulting in pAR one and two months after vaccination. Higher age at vaccination was identified as predictors of impaired pAR. The efficacy of vaccination may be more pronounced in younger RA patients. The vaccine is safe in RA patients on ETA. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

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The Effect of tumor necrosis factor blockade on the response to pneumococcal vaccination in patients with rheumatoid arthritis and ankylosing spondylitis

Cited by 162 publications

References 23 publications

In vitro Cytokine Synthesis by Lymphocytes in Children in Juvenile Idiopathic Arthritis Remission Against the Background of Genetically Engineered Biologic Drug Therapy

In vitro Cytokine Synthesis by Lymphocytes in Children in Juvenile Idiopathic Arthritis Remission Against the Background of Genetically Engineered Biologic Drug Therapy

Inflammatory Bowel Disease in Older People

FRI0292 Efficacy of A Conjugated Pneumococcus Vaccine in Rheumatoid Arthritis Patients Treated with Etanercept

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