Document Detail

TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients.
MedLine Citation:
PMID:  22908326     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the immunogenicity of the anti-influenza A H1N1/2009 vaccine in RA and spondyloarthritis (SpA) patients receiving distinct classes of anti-TNF agents compared with patients receiving DMARDs and healthy controls.
METHODS: One hundred and twenty patients (RA, n = 41; AS, n = 57; PsA, n = 22) on anti-TNF agents (monoclonal, n = 94; soluble receptor, n = 26) were compared with 116 inflammatory arthritis patients under DMARDs and 117 healthy controls. Seroprotection, seroconversion (SC), geometric mean titre, factor increase in geometric mean titre and adverse events were evaluated 21 days after vaccination.
RESULTS: After immunization, SC rates (58.2% vs 74.3%, P = 0.017) were significantly lower in SpA patients receiving anti-TNF therapy, whereas no difference was observed in RA patients receiving this therapy compared with healthy controls (P = 0.067). SpA patients receiving mAbs (infliximab/adalimumab) had a significantly lower SC rate compared with healthy controls (51.6% vs 74.3%, P = 0.002) or those on DMARDs (51.6% vs 74.7%, P = 0.005), whereas no difference was observed for patients on etanercept (86.7% vs 74.3%, P = 0.091). Further analysis of non-seroconverting and seroconverting SpA patients revealed that the former group had a higher mean age (P = 0.003), a higher frequency of anti-TNF (P = 0.031) and mAbs (P = 0.001) and a lower frequency of MTX (P = 0.028). In multivariate logistic regression, only older age (P = 0.015) and mAb treatment (P = 0.023) remained significant factors for non-SC in SpA patients.
CONCLUSION: This study revealed a distinct disease pattern of immune response to the pandemic influenza vaccine in inflammatory arthritis patients receiving anti-TNF agents, illustrated by a reduced immunogenicity solely in SpA patients using mAbs.
Ivan Leonardo Avelino França; Ana Cristina Medeiros Ribeiro; Nádia Emi Aikawa; Carla Gonçalves Schain Saad; Julio Cesar Bertacine Moraes; Cláudia Goldstein-Schainberg; Ieda Maria Magalhães Laurindo; Alexander Roberto Precioso; Maria Akiko Ishida; Ana Marli Christovam Sartori; Clovis Artur Silva; Eloisa Bonfa
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-08-20
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  51     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-22     Completed Date:  2013-01-02     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  2091-8     Citation Subset:  AIM; IM    
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MeSH Terms
Antibodies, Monoclonal / therapeutic use
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / drug therapy,  immunology*
Influenza A Virus, H1N1 Subtype / immunology*
Influenza Vaccines / immunology*
Influenza, Human / immunology*,  prevention & control
Middle Aged
Spondylarthropathies / immunology*
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/Influenza Vaccines; 0/Tumor Necrosis Factor-alpha

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