Abstract | INTRODUCTION: METHODS: A cohort of 497 patients (RA=248 and SpA=249) received a single dose of PCV7. At vaccination, patients were treated with methotrexate (MTX; n=85), anti-tumour necrosis factor (anti-TNF) + MTX (n=169), anti-TNF monotherapy (n=158) and non-steroidal anti-inflammatory drugs ( NSAIDs)/ analgesics (n=85). Antibody levels of serotypes 6B and 23B were analyzed before and 4 to 6 weeks after vaccination using standard enzyme-linked immunosorbent assay (ELISA). Serious pneumococcal infections ( pneumonia/lower respiratory tract infection, meningitis, sepsis, septic arthritis) occurring within 4.5 years after vaccination were identified in the Skåne Healthcare Register using the International Classification of Diseases, tenth revision (ICD-10) codes. The association between post-vaccination antibody levels and protection against infections and determination of protective cutoff levels was explored using receiver operating characteristic (ROC) curves. Predictors of infection were studied using regression analyses. RESULTS: Eighteen infections were registered in 15 patients before vaccination and 27 infections in 23 patients after vaccination. Patients with serious infections after vaccination had significantly lower post-vaccination antibody titres for both 6B (P=0.04) and 23 F (P=0.04). Post-vaccination antibody levels of at least 1.29 mg/L and 1.01 mg/L for 6B and 23, respectively, were associated with better protection from serious infections. Higher age, concomitant prednisolone but not MTX or anti-TNF were associated with such infections. CONCLUSIONS: TRIAL REGISTRATION NUMBER: EudraCT EU 2007-006539-29 and NCT00828997 . Registered 23 January 2009.
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Authors | Johanna Nagel, Pierre Geborek, Tore Saxne, Göran Jönsson, Martin Englund, Ingemar F Petersson, Jan-Åke Nilsson, Lennart Truedsson, Meliha C Kapetanovic |
Journal | Arthritis research & therapy
(Arthritis Res Ther)
Vol. 17
Pg. 124
(May 19 2015)
ISSN: 1478-6362 [Electronic] England |
PMID | 25986458
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Bacterial
- Heptavalent Pneumococcal Conjugate Vaccine
- Immunologic Factors
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Bacterial
(blood)
- Arthritis, Rheumatoid
(blood, complications, immunology)
- Chronic Disease
- Enzyme-Linked Immunosorbent Assay
- Female
- Heptavalent Pneumococcal Conjugate Vaccine
(therapeutic use)
- Humans
- Immunization
(methods)
- Immunologic Factors
(therapeutic use)
- Male
- Middle Aged
- Pneumococcal Infections
(complications, microbiology, prevention & control)
- Young Adult
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