TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author FRANCA, Ivan Leonardo Avelino FMUSP-HC
RIBEIRO, Ana Cristina Medeiros FMUSP-HC
AIKAWA, Nadia Emi FMUSP-HC
SAAD, Carla Goncalves Schain FMUSP-HC
MORAES, Julio Cesar Bertacine FMUSP-HC
GOLDSTEIN-SCHAINBERG, Claudia FMUSP-HC
LAURINDO, Ieda Maria Magalhaes FMUSP-HC
PRECIOSO, Alexander Roberto FMUSP-HC
ISHIDA, Maria Akiko
SARTORI, Ana Marli Christovam FMUSP-HC
SILVA, Clovis Artur FMUSP-HC
BONFA, Eloisa FMUSP-HC
dc.date.issued 2012
dc.identifier.citation RHEUMATOLOGY, v.51, n.11, p.2091-2098, 2012
dc.identifier.issn 1462-0324
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/485
dc.description.abstract Methods. One hundred and twenty patients (RA, n = 41; AS, n = 57; PsA, n = 22) on anti-TNF agents (monoclonal, n = 94; soluble receptor, n = 26) were compared with 116 inflammatory arthritis patients under DMARDs and 117 healthy controls. Seroprotection, seroconversion (SC), geometric mean titre, factor increase in geometric mean titre and adverse events were evaluated 21 days after vaccination. Results. After immunization, SC rates (58.2% vs 74.3%, P = 0.017) were significantly lower in SpA patients receiving anti-TNF therapy, whereas no difference was observed in RA patients receiving this therapy compared with healthy controls (P = 0.067). SpA patients receiving mAbs (infliximab/adalimumab) had a significantly lower SC rate compared with healthy controls (51.6% vs 74.3%, P = 0.002) or those on DMARDs (51.6% vs 74.7%, P = 0.005), whereas no difference was observed for patients on etanercept (86.7% vs 74.3%, P = 0.091). Further analysis of non-seroconverting and seroconverting SpA patients revealed that the former group had a higher mean age (P = 0.003), a higher frequency of anti-TNF (P = 0.031) and mAbs (P = 0.001) and a lower frequency of MTX (P = 0.028). In multivariate logistic regression, only older age (P = 0.015) and mAb treatment (P = 0.023) remained significant factors for non-SC in SpA patients. Conclusion. This study revealed a distinct disease pattern of immune response to the pandemic influenza vaccine in inflammatory arthritis patients receiving anti-TNF agents, illustrated by a reduced immunogenicity solely in SpA patients using mAbs. Trial Registration: ClinicalTrials.gov, ext-link-type=""uri"" xlink:href=""www.clinicaltrials.gov"" xmlns:xlink=""http://www.w3.org/1999/xlink"">www.clinicaltrials.gov, NCT01151644.
dc.description.sponsorship · Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [FAPESP 2009/51897-5, 2010/10749-0]
· Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [CNPQ 302724/2011-7, 301411/2009-3]
· Federico Foundation
· Butantan Foundation
dc.language.iso eng
dc.publisher OXFORD UNIV PRESS
dc.relation.ispartof Rheumatology
dc.rights restrictedAccess
dc.subject vaccine; pandemic influenza A (H1N1); biologic agents; rheumatic disease; TNF blockers
dc.subject.other systemic-lupus-erythematosus; necrosis-factor antagonists; rheumatoid-arthritis; anti-tnf; disease; immunogenicity; criteria; safety; classification; adjuvant
dc.title TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients
dc.type article
dc.rights.holder Copyright OXFORD UNIV PRESS
dc.description.group LIM/17
dc.description.group LIM/36
dc.description.group LIM/48
dc.identifier.doi 10.1093/rheumatology/kes202
dc.identifier.pmid 22908326
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author FRANCA, Ivan Leonardo Avelino:FM:
hcfmusp.author RIBEIRO, Ana Cristina Medeiros:FM:
hcfmusp.author AIKAWA, Nadia Emi:FM:
hcfmusp.author SAAD, Carla Goncalves Schain:FM:
hcfmusp.author MORAES, Julio Cesar Bertacine:FM:
hcfmusp.author GOLDSTEIN-SCHAINBERG, Claudia:HC:LIM/17
hcfmusp.author LAURINDO, Ieda Maria Magalhaes:HC:ICHC
hcfmusp.author PRECIOSO, Alexander Roberto:HC:ICR
hcfmusp.author SARTORI, Ana Marli Christovam:HC:ICHC
hcfmusp.author SILVA, Clovis Artur:HC:ICR
hcfmusp.author BONFA, Eloisa:FM:MCM
hcfmusp.author.external · ISHIDA, Maria Akiko:Univ Sao Paulo, Fac Med, Inst Adolfo Lutz, BR-05403010 Sao Paulo, Brazil
hcfmusp.origem.id 2-s2.0-84867774746
hcfmusp.origem.id WOS:000310154300024
hcfmusp.publisher.city OXFORD
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 37
hcfmusp.citation.wos 33
hcfmusp.affiliation.country Brasil


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