TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients


Autoria(s): Avelino Franca, Ivan Leonardo; Medeiros Ribeiro, Ana Cristina; Aikawa, Nadia Emi; Schain Saad, Carla Goncalves; Bertacine Moraes, Julio Cesar; Goldstein-Schainberg, Claudia; Magalhaes Laurindo, Ieda Maria; Precioso, Alexander Roberto; Ishida, Maria Akiko; Christovam Sartori, Ana Marli; Silva, Clovis Artur; Bonfa, Eloisa
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

14/10/2013

14/10/2013

2012

Resumo

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. Trial Registration: ClinicalTrials.gov, ext-link-type="uri" xlink:href="www.clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.clinicaltrials.gov, NCT01151644.

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [FAPESP 2009/51897-5, 2010/10749-0]

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [CNPQ 302724/2011-7, 301411/2009-3]

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico

Federico Foundation

Federico Foundation

Butantan Foundation

Butantan Foundation

Identificador

RHEUMATOLOGY, OXFORD, v. 51, n. 11, supl. 4, Part 1-2, pp. 2091-2098, NOV, 2012

1462-0324

http://www.producao.usp.br/handle/BDPI/34467

10.1093/rheumatology/kes202

http://dx.doi.org/10.1093/rheumatology/kes202

Idioma(s)

eng

Publicador

OXFORD UNIV PRESS

OXFORD

Relação

RHEUMATOLOGY

Direitos

closedAccess

Copyright OXFORD UNIV PRESS

Palavras-Chave #VACCINE #SAFETY #IMMUNOGENICITY #PANDEMIC INFLUENZA A (H1N1) #BIOLOGIC AGENTS #RHEUMATIC DISEASE #TNF BLOCKERS #SYSTEMIC-LUPUS-ERYTHEMATOSUS #NECROSIS-FACTOR ANTAGONISTS #RHEUMATOID-ARTHRITIS #ANTI-TNF #DISEASE #IMMUNOGENICITY #CRITERIA #SAFETY #CLASSIFICATION #ADJUVANT #RHEUMATOLOGY
Tipo

article

original article

publishedVersion