Annals of the rheumatic diseases · 2008
Wegener's granulomatosis patients show an adequate antibody response to influenza vaccination.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Holvast A, Stegeman C A, Benne C A, Huckriede A, Wilschut J C, Palache A M, Kallenberg C G M, Bijl M
Аннотация
OBJECTIVES: Wegener's granulomatosis (WG) is a systemic vasculitis characterised by relapsing and remitting disease activity. Immunosuppressive drugs are used to control disease, but increase susceptibility to infection. Therefore, influenza vaccination should be considered in WG patients. This study was performed to assess the immunogenicity of influenza vaccination in WG patients.
METHODS: A randomised, controlled trial was performed in WG patients with quiescent disease, defined as a Birmingham vasculitis activity score (BVAS) less than 2. Patients were randomly assigned to receive influenza vaccination (n = 49) or to participate as controls (n = 23). In addition, healthy controls (n = 49) were vaccinated. At entry and at 1 and 3-4 months after entry, antibody responses to vaccination were determined. Furthermore, disease activity was measured (BVAS), adverse effects were recorded and antineutrophil cytoplasmic autoantibody (ANCA) titres were determined.
RESULTS: WG patients achieved high seroprotection rates to all three influenza strains, comparable with healthy controls. Only the A/H1N1 strain patients had a lower seroconversion rate (p = 0.002) and geometric mean titre (p = 0.037) than controls. After 1 month, one control and one vaccinated WG patient had developed active disease. At 3-4 months, two additional control patients had developed active disease compared with none of the vaccinated patients (p = 0.099). Vaccination did not influence ANCA titres. Adverse effects did not differ between patients and healthy controls.
CONCLUSIONS: Influenza vaccination in WG patients with quiescent disease induced a sufficient antibody response.
TRIAL REGISTRATION NUMBER: NTR1130.
METHODS: A randomised, controlled trial was performed in WG patients with quiescent disease, defined as a Birmingham vasculitis activity score (BVAS) less than 2. Patients were randomly assigned to receive influenza vaccination (n = 49) or to participate as controls (n = 23). In addition, healthy controls (n = 49) were vaccinated. At entry and at 1 and 3-4 months after entry, antibody responses to vaccination were determined. Furthermore, disease activity was measured (BVAS), adverse effects were recorded and antineutrophil cytoplasmic autoantibody (ANCA) titres were determined.
RESULTS: WG patients achieved high seroprotection rates to all three influenza strains, comparable with healthy controls. Only the A/H1N1 strain patients had a lower seroconversion rate (p = 0.002) and geometric mean titre (p = 0.037) than controls. After 1 month, one control and one vaccinated WG patient had developed active disease. At 3-4 months, two additional control patients had developed active disease compared with none of the vaccinated patients (p = 0.099). Vaccination did not influence ANCA titres. Adverse effects did not differ between patients and healthy controls.
CONCLUSIONS: Influenza vaccination in WG patients with quiescent disease induced a sufficient antibody response.
TRIAL REGISTRATION NUMBER: NTR1130.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAntibodies, Antineutrophil CytoplasmicAntibodies, ViralCase-Control StudiesChi-Square DistributionFemaleGranulomatosis with PolyangiitisHumansImmunosuppressive AgentsInfluenza A Virus, H1N1 SubtypeInfluenza VaccinesInfluenza, HumanMaleMiddle AgedOrthomyxoviridaeProspective StudiesTreatment OutcomeVasculitis