ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 971

The Long-Term Efficacy of an Anti-Pneumococcal Polysaccharide Vaccine (PPSV23, Pneumovax) Among Autoimmune Inflammatory Rheumatic Patients

Adi Broyde1, Uri Arad2, Noa Madar-Balakinski2, Daphna Paran3, Ilana Kaufman4, Ira Litinsky5, David Levartovsky6, Irena Wigler2, Dan Caspi7 and Ori Elkayam8, 1Department of rheumatology, Tel Aviv medical center, Tel Aviv, Israel, 2Department of Rheumatology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 3Rheumatology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel, 4Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel-aviv, Israel, 5Rheumatology, Tel Aviv Sourasky Medical Ctr, Tel-Aviv University, Tel Aviv, Israel, 6Department of rheumatology. Tel Aviv Medical Center, Tel Aviv, Israel, 7Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, 8Rheumatology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel- Aviv, Israel

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: ACR/ARHP Combined Abstract Session: Epidemiology and Public Health

Session Type: Combined Abstract Sessions

Background/Purpose: Vaccination with Pneumovax is recommended for adult patients with auto-immune inflammatory rheumatic diseases (AIIRD). Re-vaccination is recommended after 5 years in this population although reports on the long term efficacy of the vaccine are scarce.The objective of this study was to estimate the long term efficacy of anti-pneumococcal vaccine (PNEUMOVAX) using the surrogate marker of humoral response in patients with AIIRD on immune-suppressing therapy and  the effect of  clinical and demographic factors as well as treatment on the long term efficacy of the vaccine.

Methods: One hundred and forty five consecutive AIIRD patients (rheumatoid arthritis (RA) (48.5%), psoriatic arthritis (PsA) (22.3%), ankylosing spondylitis (AS) (21/5%), and IBD associated arthritis) (2.3%) , (mean age 54.6, 61/5% women) treated with  biologic therapy (TNF α or Il-6 receptor  inhibitors) or Methotrexate (MTX)  participated in this study. Data including the day of vaccination, demographic, clinical charasteristics and treatment was collected. Blood samples were drawn from each patient and tested for anti-pnemococcal antibody level

Results: 67.7% had received PNEUMOVAX, with a mean time from vaccination of 45 months. Treatment included TNF α inhibitors (73.9%), Il-6 receptor inhibitors (13.1%), or MTX without a biological treatment. (13%). The uptake of vaccination was significantly higher in the elderly population (>65 y). Vaccinated patients had significantly higher antibody levels compared with unvaccinated patients. After 10 years, we did not observe a decrease in the antibody levels. The use of MTX was associated with significant lower antibody levels whereas biologics – both TNF α blockers and tocilizumab-and low dose steroids showed not such tendency.  

 Conclusion: The long term efficacy of Pneumovax vaccination seems to be  preserved among AIIRD patients for at least 10 years and its long term effect is not affected by the use of biologics while MTX might slightly impair it.. The actual recommendation for revaccination after 5 years should be reconsidered.

Disclosure:

A. Broyde,
None;

U. Arad,
None;

N. Madar-Balakinski,
None;

D. Paran,
None;

I. Kaufman,
None;

I. Litinsky,
None;

D. Levartovsky,
None;

I. Wigler,
None;

D. Caspi,
None;

O. Elkayam,
None.

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