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Abstract Number: 1752

Behçet´s Disease Activity: An Important Factor For Immunogenicity Of Unadjuvanted Influenza A/H1N1 Vaccine

Leandro L. Prado1, Carla G.S. Saad2, Julio C. B. Moraes1, Ana Cristina Medeiros Ribeiro1, Nadia E. Aikawa1, Clovis A. Silva3, Claudia G Schainberg1, Percival D Sampaio-Barros1, Alexander R. Precioso4, Maria A. Ishida5, Eloisa Bonfa6 and Celio Goncalves1, 1Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, 2Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 3Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 4Instituto Butantan, São Paulo, Brazil, 5Instituto Adolfo Lutz, São Paulo, Brazil, 6University of Sao Paulo, Rheumatology Division, São Paulo, Brazil

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Behcet's syndrome and vaccines

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Session Information

Title: Vasculitis II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Routine annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications. Influenza vaccine is recommended for all persons aged 6 months and older who do not have contraindications to vaccination. Despite those recommendations, there are no studies evaluating influenza vaccination influences on clinical manifestations in Behçet´s Disease (BD). Our objective is to evaluate short-term safety and efficacy of influenza A/California/7/2009/H1N1-like virus single vaccination and the potential deleterious effect of the vaccine in BD patients compared to healthy controls.

Methods: Eighty-five BD patients and 85 gender/age-matched healthy controls were evaluated before and 21-days after vaccination with unadjuvanted influenza A/H1N1-like virus regarding seroprotection/seroconversion, factor increase in geometric mean titre (FI-GMT), C-reactive-protein (CRP) levels and side effects. Brazilian BD Current Activity Form (BR-BDCAF) was used to assess BD activity.

Results: Seroconversion rate was significantly lower in BD patients compared to controls (69 vs. 83%, p=0.04). Similar rates of seroprotection (71 vs. 83%, p=0.06) and FI-GMT (p=0.96) were found. Interestingly, BD patients without seroconversion had significantly higher mean BR-BDCAF scores (6.0 ±4.1 vs. 3.8 ±4.3, p=0.009), with a significantly increased rate of active BD in this group (73 vs. 39%, p=0.003). Disease duration and glucocorticoid, immunosuppressors or TNF-blockers therapies did not affect seroconversion (p>0.05). Regarding side effects, patients had significantly increased rate of mild and transient reactions, such as fever (7 vs. 0%, p=0.02), headache, (27 vs. 12%, p=0.02), arthralgia (24 vs. 0.2%, p<0.001) and myalgia (25 vs. 9%, p=0.004). Moderate and severe side effects were not reported.

Conclusion: This is the first study to indicate appropriate influenza A/H1N1 vaccine safety and efficacy in BD, reinforcing its recommendation. Disease activity impaired humoral response to vaccination. Further studies are necessary to determine if a second dose would increase seroconversion rates in these patients.


Disclosure:

L. L. Prado,
None;

C. G. S. Saad,

Federico Foundation,

2;

J. C. B. Moraes,
None;

A. C. M. Ribeiro,
None;

N. E. Aikawa,
None;

C. A. Silva,
None;

C. G. Schainberg,
None;

P. D. Sampaio-Barros,
None;

A. R. Precioso,
None;

M. A. Ishida,
None;

E. Bonfa,

CNPQ #301411/2009-3,

2,

Federico Foundation,

2;

C. Goncalves,
None.

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