ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2308

The Interaction Between Human Leukocyte Antigen Class II Alleles and Seroprotection to Seasonal Influenza Vaccination in Patients with Rheumatoid Arthritis: A post-hoc Analysis

Miriam Kim 1, Jin Kyun Park 2, Eun Bong Lee 3 and Kichul Shin4, 1Seoul National University College of Medicine, Seoul, Republic of Korea, 2Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, seoul, Republic of Korea, 3Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, seoul, 4Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea., seoul, Republic of Korea

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: , ,

Session Information

Date: Tuesday, November 12, 2019

Title: RA – Diagnosis, Manifestations, & Outcomes Poster III: Comorbidities

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: There are few studies that have looked into the role of human leukocyte antigen (HLA) class II alleles in seroprotection to influenza, especially in subjects with rheumatoid arthritis (RA). We aimed to investigate the correlation between HLA class II polymorphism and the serologic response following seasonal influenza vaccination in patients with RA.

Methods: A total of 314 patients with RA were randomized to continue MTX (MTX-CONT) or to hold MTX (MTX-HOLD) for 2 weeks after vaccination with 2016–2017 seasonal quadrivalent influenza vaccine that contained H1N1, H3N2, B-Yamagata and Victoria (Clinicaltrials.gov NCT02897011). Positive vaccine response was defined as a ≥ 4-fold increase in the hemagglutination inhibition antibody titer, and a satisfactory vaccine response was defined to have a positive response in ≥ 2 of four vaccine antigens. Patients were typed for HLA-DRB1, -DQB1, -DQA1, and -DPB1 using the PCR sequence-based typing method, and its allele profiles were analyzed with the SBTengine software. Antigen frequencies in percentage (AgF%) were compared in responder and non-responder groups using the Chi-square test.

Results: Baseline characteristics of both MTX-CONT (n= 155) and MTX-HOLD (n= 159) groups were comparable, as well as the AgF% of four HLA class II genes. In the MTX-HOLD patients, two alleles were associated with a satisfactory vaccine response: the HLA-DRB1*11:01 allele was detected at significantly higher frequencies in responders to H1N1 (p= 0.046, odds ratio, OR 6.33), H3N2 (p= 0.031, OR 9.87), and Victoria (p= 0.043, OR 8.29). The HLA-DQB1*03:02 allele frequency was significantly higher in responders to H3N2 (p= 0.017, OR 3.69) and Victoria (p= 0.047, OR 2.29). These AgF%-responder associations were nonexistent in the MTX-CONT group. There was no HLA class II antigen frequency associated with responders to B-Yamagata in both groups.

Conclusion: Our data indicate that holding MTX after influenza vaccination could lead to better seroprotection in RA patients with HLA-DRB1*11:01 or -DQB1*03:02. Further study is needed to elucidate the mechanisms of higher antibody response to influenza antigens in this subset of patients.

Reference

  1. Park JK, Lee YJ, Shin K, et al. Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomized clinical trial. Ann Rheum Dis. 2018 Jun;77(6):898-904.

  1. Moss AJ, Gaughran FP, Karasu A, et al. Correlation between human leukocyte antigen class II alleles and HAI titers detected post-influenza vaccination.PLoS One. 2013 Aug 9;8(8):e71376. 
Disclosure: M. Kim, None; J. Park, None; E. Lee, Seoul National University Hospital, 3; K. Shin, None.

To cite this abstract in AMA style:

Kim M, Park J, Lee E, Shin K. The Interaction Between Human Leukocyte Antigen Class II Alleles and Seroprotection to Seasonal Influenza Vaccination in Patients with Rheumatoid Arthritis: A post-hoc Analysis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/the-interaction-between-human-leukocyte-antigen-class-ii-alleles-and-seroprotection-to-seasonal-influenza-vaccination-in-patients-with-rheumatoid-arthritis-a-post-hoc-analysis/. Accessed .

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