• Patricia Richi, María Dolores Martín, María Teresa Navío, Laura González-Hombrado, Marina Salido, Jesús Llorente, Israel Thuissard-Vasallo, Patricia Alcocer, Carmen María Saa-Requejo, Ana Jiménez-Diaz, Laura Cebrián, Leticia Lojo, Marta García-Castro, David Sanz-Rosa, Patricia Castro, Sandra Fernández-Rodríguez, María José Martínez de Aramayona, Martina Steiner, Tatiana Cobo, Cristina García-Fernández, Mónica Fernández-Castro, Óscar Illera, Ricardo Valverde, and Santiago Muñoz-Fernández.
• Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain. Electronic address: patricia.richi@salud.madrid.org.
• Med Clin (Barc). 2019 Nov 29; 153 (10): 380-386.

Background And ObjectivesInfluenza vaccine is recommended for patients with autoimmune inflammatory rheumatic diseases who receive biological therapy. To evaluate if biological therapy impairs immunization after seasonal influenza vaccine.Material And MethodsPatients with inflammatory arthopathies, psoriasis, inflammatory bowel disease or connective tissue diseases who were receiving or were going to initiate biological therapy were included and vaccinated during 2014-2015 influenza season. ELISA was used to measure influenza antigen A and B antibodies, before and after vaccination. Demographic parameters, diagnosis and kind of treatment were recorded and their influence on the final serological status against influenza was studied.Results253 subjects were analyzed. After vaccination, 77% of participants presented detectable antibodies against antigen A and 50.6% of them had detectable antibodies against antigen B. Final seropositivity rate against antigen B antibodies increased from baseline (50.6% vs 43.5%, p<0.001). Anti-TNF drugs were associated with better response and rituximab with the worst (79.2% vs 55.0% for final seropositivity against antigen A, p=0.020). Vaccine response in the rituximab group tended to improve when the interval between the drug administration and the vaccination was at least 12 weeks (seropositivity rate 80.0% in those with the longer interval vs 25.0% in the other group, p=0.054).ConclusionsAmong the patients on biological therapy vaccinated against influenza, anti-TNF therapy was identified as a predictive factor of final seropositivity. Rituximab presented a lower rate of final seropositivity, which could be increased with an accurate administration schedule.Copyright © 2019 Elsevier España, S.L.U. All rights reserved.

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