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See Latest ArticlesThe effect of infliximab and timing of vaccination on the humoral response to influenza vaccination in patients with rheumatoid arthritis and ankylosing spondylitis
Seminars in Arthritis and Rheumatism, 06/23/09
Elkayam O et al. – Study reports that influenza virus vaccine generated a good humoral response in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients treated with infliximab.
Methods- An assessment of the effect of the timing of vaccination in relation to administration of infliximab on the efficacy and safety of influenza vaccine in pts with RA and AS
- 38 pts treated with infliximab at a mean dosage of 3 mg/kg:
- 20 RA pts; 18 AS pts
- 23 RA controls treated with DMARDs other than anti-TNF-α and
- 17 healthy controls
- Pts treated with infliximab were divided into 2 groups:
- 22 were vaccinated on the day of administration of infliximab
- 16 received the vaccine 3 wks after infliximab
- Baseline and 4- to 6-wk clinical assessment of disease activity included ESR and CRP for all pts, the DAS28 for RA pts, and BASDAI for AS pts
- Hemagglutination inhibition (HI) Abs were tested by a standard WHO procedure
- Response was defined as ≥4-fold rise in HI Abs 4 to 6 wks after vaccination, or seroconversion in pts with a nonprotective baseline level of Abs
- Geometric mean titers (GMT) were calculated to assess the immunity of the whole group
- At baseline, RA pts and controls had similar occurrence of protective levels of HI Abs and GMT
- AS pts had lower levels reflecting lower rates of previous vaccination
- 4 wks after vaccination, a similar increase in GMT for each antigen was observed in all groups except in the RA-infliximab group, vaccinated 3 wks after admin. of infliximab, in whom the increase in GMT was not significant for H1N1
- AS pts demonstrated an increase in GMT, independently of the time of vaccination
- The percentage of responders was similar in all groups
- Response was not affected by variables such as age, gender, MTX, or prednisone use
- Parameters of disease activity remained unchanged
- No AEs other than injection site pain were recorded
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