Background/Purpose: Patients with psoriatic arthritis (PsA) and psoriasis (Pso) are considered to be immunosuppressed and are therefore recommended to receive vaccination against seasonal influenza. However, in this population of patients, data on the efficacy and safety of vaccination against influenza is scarce.The purpose of this study was to assess the efficacy and safety of vaccination against seasonal influenza in psoriatic arthritis and psoriasis patients.

Methods: Patients with PsA, Pso and healthy controls were vaccinated using the Sanofi Pasteur vaccine recommended by the WHO in 2012 which included 3 serotypes (A/California/7/2009, A/Victoria/361/2011 and aB/Wisconsin/1/2010 influenza virus i.eH1N1, H2N3 and B). Clinical and laboratory assessment were performed on the day of the vaccination and 4-6 weeks later. The immunogenicity of the vaccine was evaluated by hemagglutination inhibition assay. Geometric mean titers and the rate of seroconversion was analyzed in each group. The effect of the vaccine on disease activity  was evaluated using 68 tender and 66 joint counts, number of  dactylitis, psoriasis area severity index (PASI), patient visual analogue scale (VAS) for pain, physician VAS for pain, c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).     

Results:

67 patients (63 PsA, 4 Pso, mean age 50.1, 37 female, 30 male, 55.2% treated with TNF α blockers, 31.3% on disease-modifying anti rheumatic drugs (DMARDs) ) and 30 healthy controls participated in this study. Immunogenicity: The geometric mean titers increased significantly in both the patients and control group for each of the subtypes tested. A substantial and similar proportion of patients in both groups responded to the vaccine. The response rate was not affected by parameters such as age, gender, disease activity or the use of TNF α blockers or DMARDs. Effect of the vaccine on parameters of disease activity: no significant changes were observed in the tender and swollen joint counts, dactylitis, PASI, global evaluation of the patient and physician and ESR, while a raise in CRP was noticed. The most common side effect was transient local inflammation at the site of vaccination, the rate being similar in both groups.

Conclusion:

Vaccination against seasonal influenza is safe and induces an appropriate response in patients with psoriatic arthritis and psoriasis, similar to healthy controls.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-and-safety-of-vaccination-against-seasonal-2012-influenza-virus-among-patients-with-psoriatic-arthritis-and-psoriasis/