Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis.

C Kapetanovic, Meliha; Saxne, Tore; Sjöholm, Anders; Truedsson, Lennart; Jönsson, Göran; Geborek, Pierre

Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis.

Mark

C Kapetanovic, Meliha ^LU ; Saxne, Tore ^LU ; Sjöholm, Anders ^LU ; Truedsson, Lennart ^LU ; Jönsson, Göran ^LU and Geborek, Pierre ^LU (2006) In Rheumatology 45(1). p.106-111

Abstract: Objective. To compare antibody responses to 23-valent pneumococcal vaccine (Pneumovax (R)) in controls and patients with established rheumatoid arthritis (RA) treated with TNF blockers, methotrexate (MTX) or a combination of both. Methods. Patients with RA (n = 149) and healthy controls (n = 47) were vaccinated. Treatment with TNF blockers (etanercept or infliximab) and MTX was given to 50 patients, and 62 patients were treated with TNF blockers alone or with other DMARDs. MTX alone was given to 37 patients. Concentrations of immunoglobulin G (IgG) antibodies against pneumococcal capsular polysaccharides 23F and 6B were measured by enzyme-linked immunoassay before and 4-6 weeks after vaccination. An immune response was defined as a twofold... (More); Objective. To compare antibody responses to 23-valent pneumococcal vaccine (Pneumovax (R)) in controls and patients with established rheumatoid arthritis (RA) treated with TNF blockers, methotrexate (MTX) or a combination of both. Methods. Patients with RA (n = 149) and healthy controls (n = 47) were vaccinated. Treatment with TNF blockers (etanercept or infliximab) and MTX was given to 50 patients, and 62 patients were treated with TNF blockers alone or with other DMARDs. MTX alone was given to 37 patients. Concentrations of immunoglobulin G (IgG) antibodies against pneumococcal capsular polysaccharides 23F and 6B were measured by enzyme-linked immunoassay before and 4-6 weeks after vaccination. An immune response was defined as a twofold or higher increase in antibody concentration following vaccination. Results. Prevaccination antibody levels for both 23F and 6B were similar in the patient groups. Antibody concentrations after vaccination increased significantly in all groups. Patients treated with TNF blockers without MTX showed better immune responses than those treated with TNF blockers in combination with MTX (P = 0.037 for 23F and P = 0.004 for 6B) or MTX alone (P < 0.001 for both 23F and 6B). RA patients given MTX alone had the lowest immune responses. Prednisolone treatment did not influence the responses. Conclusions. Patients treated with TNF blockers and controls showed similar responses to vaccination. In contrast, patients treated with MTX had reduced responses regardless of anti-TNF treatment. The findings do not argue against the use of pneumococcal vaccination in RA patients undergoing treatment with TNF blockers. (Less)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/147938

author

C Kapetanovic, Meliha ^LU ; Saxne, Tore ^LU ; Sjöholm, Anders ^LU ; Truedsson, Lennart ^LU ; Jönsson, Göran ^LU and Geborek, Pierre ^LU

organization

publishing date

2006

type

Contribution to journal

publication status

published

subject

Rheumatology and Autoimmunity

keywords

TNF blockers, pneumococcal vaccination, antibody response, prednisolone, rheumatoid arthritis, methotrexate

in

Rheumatology

volume

45

issue

1

pages

106 - 111

publisher

Oxford University Press

external identifiers

wos:000234220600021
pmid:16287919
scopus:29844450347

ISSN

1462-0332

DOI

10.1093/rheumatology/kei193

language

English

LU publication?

yes

additional info

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Infection Medicine (SUS) (013008000), Department of Rheumatology (013036000), Division of Microbiology, Immunology and Glycobiology - MIG (013025200)

id

5558053c-91f5-405e-b5e1-c35e761708c9 (old id 147938)

alternative location

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16287919&dopt=Abstract

date added to LUP

2016-04-01 16:28:44

date last changed

2022-03-15 00:34:33

@article{5558053c-91f5-405e-b5e1-c35e761708c9,
  abstract     = {{Objective. To compare antibody responses to 23-valent pneumococcal vaccine (Pneumovax (R)) in controls and patients with established rheumatoid arthritis (RA) treated with TNF blockers, methotrexate (MTX) or a combination of both. Methods. Patients with RA (n = 149) and healthy controls (n = 47) were vaccinated. Treatment with TNF blockers (etanercept or infliximab) and MTX was given to 50 patients, and 62 patients were treated with TNF blockers alone or with other DMARDs. MTX alone was given to 37 patients. Concentrations of immunoglobulin G (IgG) antibodies against pneumococcal capsular polysaccharides 23F and 6B were measured by enzyme-linked immunoassay before and 4-6 weeks after vaccination. An immune response was defined as a twofold or higher increase in antibody concentration following vaccination. Results. Prevaccination antibody levels for both 23F and 6B were similar in the patient groups. Antibody concentrations after vaccination increased significantly in all groups. Patients treated with TNF blockers without MTX showed better immune responses than those treated with TNF blockers in combination with MTX (P = 0.037 for 23F and P = 0.004 for 6B) or MTX alone (P &lt; 0.001 for both 23F and 6B). RA patients given MTX alone had the lowest immune responses. Prednisolone treatment did not influence the responses. Conclusions. Patients treated with TNF blockers and controls showed similar responses to vaccination. In contrast, patients treated with MTX had reduced responses regardless of anti-TNF treatment. The findings do not argue against the use of pneumococcal vaccination in RA patients undergoing treatment with TNF blockers.}},
  author       = {{C Kapetanovic, Meliha and Saxne, Tore and Sjöholm, Anders and Truedsson, Lennart and Jönsson, Göran and Geborek, Pierre}},
  issn         = {{1462-0332}},
  keywords     = {{TNF blockers; pneumococcal vaccination; antibody response; prednisolone; rheumatoid arthritis; methotrexate}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{106--111}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology}},
  title        = {{Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis.}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/kei193}},
  doi          = {{10.1093/rheumatology/kei193}},
  volume       = {{45}},
  year         = {{2006}},
}

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Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis.