NADIA EMI AIKAWA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
conferenceObject EXPOSURE TO ENVIRONMENTAL FACTORS DURING PREGNANCY AND AFTER BIRTH TO THE BEGINNING OF JUVENILE IDIOPATHIC ARTHRITIS(2015) FRANCA, C. M. P.; SALLUM, A. M. E.; SILVA, C. A.; AIKAWA, N. E.; BRAGA, A. L. F.; FARHAT, S. C. L.- EARLY SACROILIITIS AND PROGRESSION TO ANKYLOSING SPONDYLITIS IS ASSOCIATED TO POSITIVE HLA-B27 IN JUVENILE SPONDYLOARTHRITIS(2015) PEREZ, M. O.; AIKAWA, N. E.; CARRASCO, S.; SAAD, C. G.; SAMPAIO-BARROS, P. D.; GONCALVES, C. R.; MORAES, J. C. B.; GOLDENSTEIN-SCHAINBERG, C.
- Immunogenicity and safety of the 2009 non-adjuvanted influenza A/H1N1 vaccine in a large cohort of autoimmune rheumatic diseases(2011) SAAD, Carla G. S.; BORBA, Eduardo F.; AIKAWA, Nadia E.; SILVA, Clovis A.; PEREIRA, Rosa M. R.; CALICH, Ana Luisa; MORAES, Julio C. B.; RIBEIRO, Ana C. M.; VIANA, Vilma S. T.; PASOTO, Sandra G.; CARVALHO, Jozelio F.; FRANCA, Ivan L. A.; GUEDES, Lissiane K. N.; SHINJO, Samuel K.; SAMPAIO-BARROS, Percival D.; CALEIRO, Maria T.; GONCALVES, Celio R.; FULLER, Ricardo; LEVY-NETO, Mauricio; TIMENETSKY, Maria do Carmo S.; PRECIOSO, Alexander R.; BONFA, EloisaBackground Despite the WHO recommendation that the 2010-2011 trivalent seasonal flu vaccine must contain A/California/7/2009/H1N1-like virus there is no consistent data regarding its immunogenicity and safety in a large autoimmune rheumatic disease (ARD) population. Methods 1668 ARD patients (systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic sclerosis, psoriatic arthritis (PsA), Behcet's disease (BD), mixed connective tissue disease, primary antiphospholipid syndrome (PAPS), dermatomyositis (DM), primary Sjogren's syndrome, Takayasu's arteritis, polymyositis and Granulomatosis with polyangiitis (Wegener's) (GPA)) and 234 healthy controls were vaccinated with a non-adjuvanted influenza A/California/7/2009(H1N1) virus-like strain flu. Subjects were evaluated before vaccination and 21 days post-vaccination. The percentage of seroprotection, seroconversion and the factor increase in geometric mean titre (GMT) were calculated. Results After immunisation, seroprotection rates (68.5% vs 82.9% p < 0.0001), seroconversion rates (63.4% vs 76.9%, p < 0.001) and the factor increase in GMT (8.9 vs 13.2 p < 0.0001) were significantly lower in ARD than controls. Analysis of specific diseases revealed that seroprotection significantly reduced in SLE (p < 0.0001), RA (p < 0.0001), PsA (p=0.0006), AS (p=0.04), BD (p=0.04) and DM (p=0.04) patients than controls. The seroconversion rates in SLE (p < 0.0001), RA (p < 0.0001) and PsA (p=0.0006) patients and the increase in GMTs in SLE (p < 0.0001), RA (p < 0.0001) and PsA (p < 0.0001) patients were also reduced compared with controls. Moderate and severe side effects were not reported. Conclusions The novel recognition of a diverse vaccine immunogenicity profile in distinct ARDs supports the notion that a booster dose may be recommended for diseases with suboptimal immune responses. This large study also settles the issue of vaccine safety. (ClinicalTrials.gov #NCT01151644)
- SARS-COV-2 VACCINE IN SPONDYLOARTHRITIS PATIENTS: OVERALL MODERATE/HIGH IMMUNOGENICITY IMPAIRED BY IMMUNOSUPPRESSANTS AND BIOLOGICAL THERAPY(2022) SAAD, C.; SILVA, M. Rodrigues; SAMPAIO-BARROS, P. Degrava; MORAES, J.; GOLDENSTEIN-SCHAINBERG, C.; AIKAWA, N.; NEVES, E.; PASOTO, S.; PEDROSA, T.; AOYAMA, R. Kenji; ARAUJO, C. Scognamiglio Renner; SILVA, C.; RIBEIRO, A. C. Medeiros; BONFA, E.
- Increment of immunogenicity after third dose of a homologous inactivated SARS-CoV-2 vaccine in a large population of patients with autoimmune rheumatic diseases(2022) AIKAWA, Nadia Emi; KUPA, Leonard de Vinci Kanda; MEDEIROS-RIBEIRO, Ana Cristina; SAAD, Carla Goncalves Schahin; YUKI, Emily Figueiredo Neves; PASOTO, Sandra Gofinet; ROJO, Priscila Tagliaferro; PEREIRA, Rosa Maria Rodrigues; SHINJO, Samuel Katsuyuki; SAMPAIO-BARROS, Percival Degrava; ANDRADE, Danieli Castro Oliveira; HALPERN, Ari Stiel Radu; FULLER, Ricardo; SOUZA, Fernando Henrique Carlos; GUEDES, Lissiane Karine Noronha; ASSAD, Ana Paula Luppino; MORAES, Julio Cesar Bertacini de; LOPES, Michelle Remiao Ugolini; MARTINS, Victor Adriano de Oliveira; BETANCOURT, Lorena; RIBEIRO, Carolina Torres; SALES, Lucas Peixoto; BERTOGLIO, Isabela Maria; BONOLDI, Virginia Lucia Nazario; MELLO, Renata Lys Pinheiro; BALBI, Gustavo Guimaraes Moreira; SARTORI, Ana Marli Christovam; ANTONANGELO, Leila; SILVA, Clovis Artur; BONFA, EloisaObjective To determine the immunogenicity of the third dose of CoronaVac vaccine in a large population of patients with autoimmune rheumatic diseases (ARD) and the factors associated with impaired response. Methods Adult patients with ARD and age-balanced/sex-balanced controls (control group, CG) previously vaccinated with two doses of CoronaVac received the third dose at D210 (6 months after the second dose). The presence of anti-SARS-CoV-2 S1/S2 IgG and neutralising antibodies (NAb) was evaluated previously to vaccination (D210) and 30 days later (D240). Patients with controlled disease suspended mycophenolate mofetil (MMF) for 7 days or methotrexate (MTX) for 2 weekly doses after vaccination. Results ARD (n=597) and CG (n=199) had comparable age (p=0.943). Anti-S1/S2 IgG seropositivity rates significantly increased from D210 (60%) to D240 (93%) (p<0.0001) in patients with ARD. NAb positivity also increased: 38% (D210) vs 81.4% (D240) (p<0.0001). The same pattern was observed for CG, with significantly higher frequencies for both parameters at D240 (p<0.05). Multivariate logistic regression analyses in the ARD group revealed that older age (OR=0.98, 95% CI 0.96 to 1.0, p=0.024), vasculitis diagnosis (OR=0.24, 95% CI 0.11 to 0.53, p<0.001), prednisone >= 5 mg/day (OR=0.46, 95% CI 0.27 to 0.77, p=0.003), MMF (OR=0.30, 95% CI 0.15 to 0.61, p<0.001) and biologics (OR=0.27, 95% CI 0.16 to 0.46, p<0.001) were associated with reduced anti-S1/S2 IgG positivity. Similar analyses demonstrated that prednisone >= 5 mg/day (OR=0.63, 95% CI 0.44 to 0.90, p=0.011), abatacept (OR=0.39, 95% CI 0.20 to 0.74, p=0.004), belimumab (OR=0.29, 95% CI 0.13 to 0.67, p=0.004) and rituximab (OR=0.11, 95% CI 0.04 to 0.30, p<0.001) were negatively associated with NAb positivity. Further evaluation of COVID-19 seronegative ARD at D210 demonstrated prominent increases in positivity rates at D240 for anti-S1/S2 IgG (80.5%) and NAb (59.1%) (p<0.0001). Conclusions We provide novel data on a robust response to the third dose of CoronaVac in patients with ARD, even in those with prevaccination COVID-19 seronegative status. Drugs implicated in reducing immunogenicity after the regular two-dose regimen were associated with non-responsiveness after the third dose, except for MTX.
- Two-week methotrexate discontinuation in patients with rheumatoid arthritis vaccinated with inactivated SARS-CoV-2 vaccine: a randomised clinical trial(2022) ARAUJO, Carlo Scognamiglio Renner; MEDEIROS-RIBEIRO, Ana Cristina; SAAD, Carla G. S.; BONFIGLIOLI, Karina Rossi; DOMICIANO, Diogo Souza; SHIMABUCO, Andrea Yukie; SILVA, Matheus Santos Rodrigues; YUKI, Emily Figueiredo Neves; PASOTO, Sandra Gofinet; PEDROSA, Tatiana; KUPA, Leonard de Vinci Kanda; ZOU, Gioanna; PEREIRA, Rosa M. R.; SILVA, Clovis Artur; AIKAWA, Nadia Emi; BONFA, EloisaObjective To evaluate the effect on immunogenicity and safety of 2-week methotrexate (MTX) discontinuation after each dose of the Sinovac-CoronaVac vaccine versus MTX maintenance in patients with rheumatoid arthritis (RA). Methods This was a single-centre, prospective, randomised, investigator-blinded, intervention study (NCT04754698, CoronavRheum) including adult patients with RA (stable Clinical Disease Activity Index (CDAI) <= 10, prednisone <= 7.5 mg/day) randomised (1:1) to withdraw MTX (MTX-hold) for 2 weeks after each vaccine dose or maintain MTX (MTX-maintain), evaluated at day 0 (D0), D28 and D69. Coprimary outcomes were anti-SARS-CoV-2 S1/S2 IgG seroconversion (SC) and neutralising antibody (NAb) positivity at D69. Secondary outcomes were geometric mean titres (GMT) and flare rates. For immunogenicity analyses, we excluded patients with baseline positive IgG/NAb, and for safety reasons those who flared at D28 (CDAI >10) and did not withdraw MTX twice. Results Randomisation included 138 patients with 9 exclusions (5 COVID-19, 4 protocol violations). Safety evaluation included 60 patients in the MTX-hold and 69 patients in the MTX-maintain group. Further exclusions included 27 patients (13 (21.7%) vs 14 (20.3%), p=0.848) with positive baseline IgG/NAb and 10 patients (21.3%) in MTX-hold with CDAI >10 at D28. At D69, the MTX-hold group (n=37) had a higher rate of SC than the MTX-maintain group (n=55) (29 (78.4%) vs 30 (54.5%), p=0.019), with parallel augmentation in GMT (34.2 (25.2-46.4) vs 16.8 (11.9-23.6), p=0.006). No differences were observed for NAb positivity (23 (62.2%) vs 27 (49.1%), p=0.217). At D28 flare, the rates were comparable in both groups (CDAI, p=0.122; Disease Activity Score in 28 joints with C reactive protein, p=0.576), whereas CDAI >10 was more frequent in MTX-hold at D69 (p=0.024). Conclusion We provided novel data that 2-week MTX withdrawal after each dose of the Sinovac-CoronaVac vaccine improves anti-SARS-CoV-2 IgG response. The increased flare rates after the second MTX withdrawal may be attributed to the short-term interval between vaccine doses. This strategy requires close surveillance and shared decision making due to the possibility of flares.
conferenceObject BEHCET'S DISEASE ACTIVITY: AN IMPORTANT FACTOR FOR IMMUNOGENECITY OF UNADJUVANTED INFLUENZA A/H1N1 VACCINE(2013) PRADO, L. L.; SAAD, C. G. S.; MORAES, J. C. B.; RIBEIRO, A. C. M.; AIKAWA, N. E.; SILVA, C. A.; SCHAINBERG, C. G.; SAMPAIO-BARROS, P. D.; PRECIOSO, A. R.; ISHIDA, M. A.; BONFA, E.; GONCALVES, C. R.- DIFFUSE ALVEOLAR HEMORRHAGE: A MULTICENTER STUDY IN 847 CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS(2017) SILVA, C. A.; BLAY, G.; RODRIGUES, J. C.; LEAL, G. N.; FERREIRA, J. C.; NOVAK, G.; PEREIRA, R. M. R.; TERRERI, M. T.; MAGALHAES, C. S.; MOLINARI, B. C.; SAKAMOTO, A. P.; AIKAWA, N. E.; CAMPOS, L. M. A.; FERNANDES, T. A. P.; CLEMENTE, G.; PERACCHI, O. A. B.; BUGNI, V.; MARINI, R.; SACCHETTI, S. B.; CARVALHO, L. M.; FRAGA, M. M.; CASTRO, T. C. M.; RAMOS, V. C.; BONFA, E.
conferenceObject INVASIVE ASPERGILLOSIS: A SEVERE INFECTION IN JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS(2012) SILVA, M. F. C.; RIBEIRO, A. S. M.; FIOROT, F. J.; AIKAWA, N. E.; LOTITO, A. P. N.; CAMPOS, L. M. A.; MAUAD, T.; SILVA, C. A.- EVANS SYNDROME AT CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS DIAGNOSIS: A LARGE MULTICENTER STUDY(2016) LUBE, G. E.; FERRIANI, M. P. L.; CAMPOS, L. M.; TERRERI, M. T.; BONFA, E.; MAGALHAES, C. S.; AIKAWA, N. E.; PIOTTO, D. P.; PERACCHI, O. A.; SANTOS, M. C.; APPENZELLER, S.; FERRIANI, V. P.; PEREIRA, R. M.; SILVA, C. A.