RESEARCH - The effect of anti-TNF treatment on the antibody response to influenza vaccination

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Ann Rheum Dis. 2008 May;67(5):713-6. Epub 2007 Oct 26.

The effect of anti-tumour necrosis factor alpha treatment on the

antibody response to influenza vaccination.

Gelinck LB, van der Bijl AE, Beyer WE, Visser LG, Huizinga TW, van

Hogezand RA, Rimmelzwaan GF, Kroon FP.

Department of Infectious Diseases, Leiden University Medical Center

(LUMC), Leiden, The Netherland.

OBJECTIVES: The effect of anti-tumour necrosis factor (TNF) therapy on

the antibody responses to vaccines is the subject of ongoing debate.

Therefore, we investigated the effect of the three currently available

anti-TNF agents on influenza vaccination outcomes in a patient

population with long-standing disease.

METHODS: In a prospective cohort study, we assessed the antibody

response upon influenza vaccination in 112 patients with long-standing

autoimmune disease treated with immunosuppressive medication either

with anti-TNF (etanercept, adalimumab or infliximab; n = 64) or

without anti-TNF (n = 48) and a control group of 18 healthy

individuals. Antibody responses were determined by haemagglutination

inhibition assay, before and 4 weeks after vaccination.

RESULTS: The proportion of individuals with a protective titre

(>or=40) after vaccination was large (80-94%) and did not

significantly differ between the three groups. Post-vaccination

geometric mean antibody titres against influenza (A/H3N2 and were

significantly lower in the 64 patients treated with anti-TNF compared

with the 48 patients not receiving anti-TNF, and the healthy controls.

CONCLUSIONS: The antibody response to influenza vaccination in

patients treated with anti-TNF is only modestly impaired. The

proportion of patients that achieves a protective titre is not

significantly diminished by the use of TNF blocking therapies.

PMID: 17965123

http://www.ncbi.nlm.nih.gov/pubmed/17965123

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