Antibody response in patients with autoimmune inflammatory rheumatic disease after pneumococcal polysaccharide prime vaccination or revaccination.

Autor: Rasmussen SL; Department of Rheumatology, North Denmark Regional Hospital, Hjoerring, Denmark.; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark., Strandbygaard LL; Department of Rheumatology, North Denmark Regional Hospital, Hjoerring, Denmark., Fuursted K; Statens Serum Institut, Bacteriological Special Diagnostics and Reference, Copenhagen, Denmark., Kragholm KH; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Leutscher P; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Rasmussen C; Department of Rheumatology, North Denmark Regional Hospital, Hjoerring, Denmark.; Centre for Clinical Research, North Denmark Regional Hospital, Hjoerring, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Jazyk: angličtina
Zdroj: Scandinavian journal of rheumatology [Scand J Rheumatol] 2023 Mar; Vol. 52 (2), pp. 174-180. Date of Electronic Publication: 2022 Jan 20.
DOI: 10.1080/03009742.2021.2008602
Abstrakt: Objective: The aim of the study was to assess the pneumococcal antibody response in autoimmune inflammatory rheumatic disease (AIIRD) patients receiving 23-valent pneumococcal polysaccharide vaccine (PPV23) as a prime vaccination or revaccination.
Method: Antibodies to 12 serotypes occurring in the commonly applied pneumococcal vaccines in Denmark were measured in AIIRD patients receiving biological disease-modifying anti-rheumatic drug (bDMARD) treatment for rheumatoid arthritis, spondyloarthritis, or psoriatic arthritis. Patients with a non-protective level of pneumococcal antibodies (geometric mean pneumococcal antibody level < 1 μg/mL) were invited to receive vaccination with PPV23 followed by control of antibody titre 3 months later.
Results: In total, 224 (74%) of 301 patients were included in the analyses, of whom 126 patients had previously received PPV23 vaccination. Post-vaccination antibody measurement revealed that only 80 patients (36%) achieved a protective level of antibodies. In a multivariable logistic regression analysis, significantly more patients without a previous PPV23 vaccination history achieved a protective antibody level compared with patients with a history of PPV23 vaccination less than 5 years ago (p = 0.005). This difference was not seen when comparing the former group with patients vaccinated 5 years ago or more. Methotrexate (MTX) treatment at the time of vaccination was associated with a non-protective antibody level (p < 0.001).
Conclusion: Only 36% of patients with a non-protective antibody level achieved a protective level in response to pneumococcal vaccination. Pneumococcal vaccination within the last 5 years and MTX treatment at the time of vaccination were independently associated with a poor antibody response.
Databáze: MEDLINE
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