Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Vaccination for influenza virus is recommended for patients with rheumatoid arthritis (RA) with underlying such as disease elderly people over the age of 65, respiratory disease, cardiovascular disease. Especially, it is believed that in general, should be vaccinated actively in patients with biologic agents. Biologic agents might suppress the immune response to influenza vaccines, but, the report is limited to the number of papers. The aim is the study to compare antibody titers changeafter influenza vaccination for rheumatoid arthritis
Methods: 182 patients with RA of our hospital received inactivetrivalent influenza vaccination. All RA patients who have been treat with methotrexate (MTX; contorol; n=48), abatacept (ABT; n=37, include the MTX combination of 18 cases), tocilizumab (TCZ; n=80, include the MTX combination of 22 cases), golimumab (GLM; n=17, include the MTX combination of 13 cases). We used commercially available inactivated trivalent influenza vaccine. Patients received a single dose of vaccine (0.5 ml). Vaccines (A/H1N1, A/H3N2, B/B-1 strains) which was used this time was a vaccine for 2012-2013 in Japan. Measuring the antibody titer prior to vaccination, again, by measuring titer one month after, examined seroprotection rates and seroconversion rate. Serum antibody titers were measured hemagglutination inhibitory assay (HI). subcutaneously from October 2012 until January 2013. For RA patients receiving biologics, the vaccination was done on the same day as biologics infusion. Seroprotection was defined as antibody titres of ≥40. Seroconversion was defined as post vaccination antibody titres of ≥40 in patients whose pre vaccination titres were <10. Seroresponse was defined as seroconversion or 4 fold increases in antibody titres of in patients whose pre-vaccination titres were ≥10.
Results: In seroprotection rate of the type B, compared to the control, group of biologic agents was higher. But, there were no difference in the seroconversion rate in all types between control and biologics. Seroprotection rate, TCZ was higher than control in type B. In type H3N2, ABT and GLM were lower than control. Seroconversion rates, ABT tended to be lower in all types and TCZ tended to be higher in all. In type H3N2, ABT was lower than control. TCZ was higher than control in type B. This tendency is more pronounced in the Biologics group used in combination with MTX, which was the lowest antibody levels in the ABT + MTX group.
Conclusion: Treatment with anti tumour necrosis factor α (anti-TNFα) agents may impair antibody response to influenza vaccination in patients with RA and other rheumatic diseases, but the response is enough to warrant influenza vaccination for such patients. Mori et al, reported that TCZ does not hamper antibody response to influenza vaccine in RA patients and Influenza vaccination is considered effective in protecting RA patients receiving TCZ therapy with or without MTX. The results of our, TCZ group did not affect the change of antibody titers as well. In ARRIVE test, Influenza vaccine seroconversion rate who patients treated with ABT, was similar to normal people. However, in our study, no significant difference, but the results were lower than the control reviews.
Disclosure:
H. Ishikawa,
AstraZeneca Pharma,
2;
D. Kida,
Mitsubishi Tanabe Pharma, Pfizer Japan, Eisai, Chugai Pharmaceutical, Abbvie,
2;
Y. Hattori,
None;
A. Kaneko,
Otsuka Pharmaceutical, Chugai Pharmaceutical, Eli Lilly and Company Japan, Santen Pharma, UCB Japan, Quintiles Transnational Japan ,
2;
T. Sato,
Otsuka Pharmaceutical, Mitsubishi Tanabe Pharma, Chugai Pharmaceutical, Abbvie,
2.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/study-of-the-antibody-titer-by-influenza-vaccination-in-rheumatoid-arthritis-patients-treated-with-biologics-in-japan/