RESEARCH - Effect of TNF blockade on the response to pneumococcal vaccination in patients with RA and AS

[Guest guest]

Semin Arthritis Rheum. 2004 Feb;33(4):283-8.

The effect of tumor necrosis factor blockade on the response to

pneumococcal vaccination in patients with rheumatoid arthritis and

ankylosing spondylitis.

Elkayam O, Caspi D, Reitblatt T, Charboneau D, Rubins JB.

Department of Rheumatology, Tel Aviv Sourasky Medical Center, Israel.

oribe14@...

OBJECTIVE: To assess the effect of anti-tumor necrosis factor (TNF)

alpha therapies on the immunogenicity of pneumococcal vaccination in

patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS).

METHODS: A group of 16 consecutive patients (11 with RA and 5 with AS)

treated either with infliximab or etanercept, and a control group of 17

age-matched RA patients treated with disease-modifying medications other

than anti-TNF-alpha, received intradeltoid injection with 0.5 mL of

pneumococcal vaccine. Pneumococcal polysaccharide (PPS)-specific IgG to

7 vaccine PPS (representing high- and low-prevalence serotypes) was

measured by enzyme-linked immunosorbent assay in sera obtained before

and 1 month after pneumococcal immunization. RESULTS: One month after

vaccination, both groups had significant increases in the geometric mean

concentration of capsule PPS-specific antibody and in the mean fold

increase in antibody levels to all 7 serotypes, compared with

prevaccination levels. However, compared with the control group, the

TNF-alpha blockade-treated patients tended to have lower antibody

increases for all the serotypes tested except serotype 14. In addition,

lower proportions of TNF-alpha blockade-treated patients responded to

pneumococcal vaccination compared with patients on other therapies.

Similarly, more TNF-alpha blockade-treated patients were poor responders

compared with patients not on anti-TNF-alpha treatment.

CONCLUSION: Treatment of groups of patients with etanercept or

infliximab does not impair their mean antibody responses to pneumococcal

vaccination. However, a larger proportion of RA patients may not respond

adequately to pneumococcal vaccination once on TNF-alpha blockade

therapies. Consequently, pneumococcal vaccination before starting

TNF-alpha blockade therapy is recommended.

PMID: 14978666

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

4978666 & dopt=Abstract & itool=iconabstr

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

Uh-oh. Too late now. I was thinking about getting a pneumonia shot this

year as well as a flu shot. I'll probably go ahead, anyway. Maybe it

will give me some protection.

Sue

On Friday, August 27, 2004, at 09:56 PM, wrote:

> However, a larger proportion of RA patients may not respond

> adequately to pneumococcal vaccination once on TNF-alpha blockade

> therapies. Consequently, pneumococcal vaccination before starting

> TNF-alpha blockade therapy is recommended.

[Guest guest]

Uh-oh. Too late now. I was thinking about getting a pneumonia shot this

year as well as a flu shot. I'll probably go ahead, anyway. Maybe it

will give me some protection.

Sue

On Friday, August 27, 2004, at 09:56 PM, wrote:

> However, a larger proportion of RA patients may not respond

> adequately to pneumococcal vaccination once on TNF-alpha blockade

> therapies. Consequently, pneumococcal vaccination before starting

> TNF-alpha blockade therapy is recommended.