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

C Kapetanovic, Meliha LU ; Saxne, Tore LU ; Sjöholm, Anders LU ; Truedsson, Lennart LU ; Jönsson, Göran LU and Geborek, Pierre LU (2006) In Rheumatology1999-01-01+01:00 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)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
TNF blockers, pneumococcal vaccination, antibody response, prednisolone, rheumatoid arthritis, methotrexate
in
Rheumatology1999-01-01+01:00
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
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
2007-07-04 09:49:24
date last changed
2019-03-12 02:49:03
@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},
  keyword      = {TNF blockers,pneumococcal vaccination,antibody response,prednisolone,rheumatoid arthritis,methotrexate},
  language     = {eng},
  number       = {1},
  pages        = {106--111},
  publisher    = {Oxford University Press},
  series       = {Rheumatology1999-01-01+01:00},
  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},
  volume       = {45},
  year         = {2006},
}