Date: Tuesday, November 12, 2019
Session Title: Infection-Related Rheumatic Disease Poster
Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: The high dose trivalent inactivated influenza vaccine (HD-TIV) contains four times the antigen dose per strain of the standard-dose inactivated influenza vaccines. HD-TIV is licensed only for persons aged 65 years and older based on immunogenicity and efficacy data. In seropositive RA, HD-TIV substantially improves the immune response to vaccination compared to a quadrivalent standard dose influenza vaccine (SD-QIV). It is unknown whether among RA patients, the increased immunogenicity of the HD-TIV is restricted to a specific age subgroup.
Methods: Between 2016 and 2018, we conducted a treatment-stratified, randomized, modified double-blind, active-controlled trial in adult seropositive RA patients (rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies) to assess antibody responses to either SD-QIV (15 μg of hemagglutinin per strain) or HD-TIV (60 μg of HA per strain) (NCT02936180). Seroconversion (SC) rates were assessed using pre- (Day 0 – D0) and post-vaccine (D28) titers determined by serum hemagglutination inhibition (HI) and microneutralization (MN) assays. In both cases, SC was defined as at least a four-fold HI or MN antibody titer increase from D0.The effect of age (adults versus elderly, cutoff age 65+ years) on SC rates were evaluated using logistic regression analysis.
Results: A total of 279 seropositive RA patients were enrolled. 140 (50.2%) received SD-QIV and 139 (49.8%) received HD-TIV. The mean age (±SD) was 61.0±12.9 and 80% were female. Results of seroconversion rates based on hemagglutination and microneutralization assays, per vaccine strain and according to RA age groups are presented in Table 1.
The benefit of the HD-TIV regarding immune protection is not restricted to elderly seropositive RA patients. The HD-TIV substantially improves immune responses to all influenza strains in adults living with RA.
To cite this abstract in AMA style:Useche M, Agnihotram R, Bernatsky S, Ward B, Colmegna I. The High Dose Influenza Vaccine Increases Immune Protection in Both Adults and Elderly Seropositive RA Patients [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/the-high-dose-influenza-vaccine-increases-immune-protection-in-both-adults-and-elderly-seropositive-ra-patients/. Accessed May 30, 2023.
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