Preview

Meditsinskiy sovet = Medical Council

Advanced search

Immunogenicity, safety and efficacy of 23-valent pneumococcal polysaccharide vaccine in patients with inflammatory joint diseases (preliminary data)

https://doi.org/10.21518/2079-701X-2021-10-172-177

Abstract

Intoduction. Currently, for the treatment of patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), basic anti-inflammatory drugs and biological drugs are widely used to effectively control the activity of the disease. However, the use of these drugs is associated with an increased risk of developing comorbid infections, some of which can be prevented by vaccination. Objective. To evaluate the immunogenicity, safety, and clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) in patients with RA and SpA.

Materials and methods. The study included 122 patients: 79 - with RA, 43-with SpA. Most patients had a history of two or more cases of lower respiratory tract infections, 2 patients reported a monthly exacerbation of chronic sinusitis, one patient reported the development of otitis media every 2-3 months. At the time of inclusion in the study, most patients received immunosuppressive therapy. PPV-23 was administered in an amount of 1 dose (0.5 ml) subcutaneously against the background of anti-rheumatic therapy. The level of antibodies to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clin-ical Diagnostics s.r.o., Czech Republic) before vaccination, 1, 3 and 12 months after vaccination. In addition, the tolerance of PPV-23, the frequency of pneumonia, and the effect on the activity of RA and SpA were evaluated (according to the dynamics of DAS28 and BASDAI).

Results. At 1, 3, and 12 months after vaccination, the concentration of antibodies to pneumococcal capsular polysaccharide was significantly higher than the baseline values, which indicates sufficient immunogenicity of PPV-23. There was no negative effect of vaccination on the activity of the underlying disease and the occurrence of new autoimmune disorders. In the majority of patients (67% - RA, 81.4% - SpA), the tolerance of the vaccine was good. During the follow-up period, none of the patients developed pneumonia. Patients suffering from frequent sinusitis and otitis media reported the absence of these infections after vaccination.

Conclusion. Preliminary results of the study indicate sufficient immunogenicity, safety, and clinical efficacy of PPV-23 in patients with RA and SpA.

About the Authors

M. M. Baranova
Nasonova Research Institute of Rheumatology
Russian Federation

Marina M. Baranova, Postgraduate Student, Laboratory for the Study of Comorbid Infections and Monitoring the Safety of Drug Therapy.

34А, Kashirskoe Shosse, Moscow, 115522



M. S. Sergeeva
Nasonova Research Institute of Rheumatology
Russian Federation

Marina S. Sergeeva, Cand. Sci. (Med.), Researcher, Laboratory for the Study of Comorbid Infections and Monitoring the Safety of Drug Therapy.

34А, Kashirskoe Shosse, Moscow, 115522



N. V. Muravyeva
Nasonova Research Institute of Rheumatology
Russian Federation

Natalia V. Muravyeva, Cand. Sci. (Med.), Researcher, Laboratory for Studying Comorbid Infections and Monitoring the Safety of Drug Therapy.

34А, Kashirskoe Shosse, Moscow, 115522



B. S. Belov
Nasonova Research Institute of Rheumatology
Russian Federation

Boris S. Belov, Dr. Sci. (Med.), Head of the Laboratory for Studying Comorbid Infections and Monitoring the Safety of Drug Therapy.

34А, Kashirskoe Shosse, Moscow, 115522



References

1. Lila A.M., Olyunin Yu.A., Gordeev A.V. Assessing the Status of Patients with Rheumatoid Arthritis: Modern Tendencies. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2020;14(2):7-13. (In Russ.) https://doi.org/10.14412/1996-7012-2020-2-7-13.

2. Belov B.S., Tarasova G.M., Bukhanova D.V. Infectious Comorbidities in Patients with Rheumatoid Arthritis: Status Praesens. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2019;13(3):102-108. (In Russ.) https://doi.org/10.14412/1996-7012-2019-3-102-108.

3. Muravyeva N.V., Belov B.S., Baranova M.M., Korotaeva T.V. Comorbid Infections in Spondyloarthritis: A Modern View of the Problem. Sovremennaya revma-tologiya = Modern Rheumatology Journal. 2020;14(4):103-110. (In Russ.) https://doi.org/10.14412/1996-7012-2020-4-103-110.

4. Belov B.S., Bukhanova D.V., Tarasova G.M., Muravyova N.V. The Problem of Lower Respiratory Tract Infections in Rheumatology: Relevance and Ways of Solution. Effektivnaya farmakoterapiya = Effective Pharmacotherapy. 2020;16(6): 58-66. (In Russ.) https://doi.org/10.33978/2307-3586-2020-16-6-58-66.

5. Atzeni F., Sarzi-Puttini P., Botsios C., Carletto A., Cipriani P, Favalli E.G. et al. Long-Term Anti-TNF Therapy and the Risk of Serious Infections in a Cohort of Patients with Rheumatoid Arthritis: Comparison of Adalimumab, Etanercept and Infliximab in the GISEA Registry. Autoimmun Rev. 2012;12(2):225-229. https://doi.org/10.1016/j.autrev.2012.06.008.

6. Atzeni F., Sarzi-Puttini P, Sebastiani M., Panetta V., Salaffi F., Iannone F. et al. Rate of Serious Infections in Spondyloarthropathy Patients Treated with Anti-Tumour Necrosis Factor Drugs: A Survey from the Italian Registry GISEA. Clin Exp Rheumatol. 2019;37(4):649-655. Available at: https://www.clinexprheumatol.org/abstract.asp?a=13134.

7. Doran M.F., Crowson C.S., Pond G.R., O'Fallon W.M., Gabriel S.E. Frequency of Infection in Patients with Rheumatoid Arthritis Compared with Controls: A Population-Based Study.Arthritis Rheum. 2002;46(9):2287-2293. https://doi.org/10.1002/art.10524.

8. Chung H.Y., Tam L.S., Chan S.C.W., Cheung J.P.Y., Wong P.Y., Ciang C.O. et al. Risk of Community-Acquired Pneumonia Requiring Hospitalization in Patients with Spondyloarthritis. Ther Adv Musculoskelet Dis. 2020;12:1759720X20962618. https://doi.org/10.1177/1759720X20962618.

9. Litvinova M.A., Muravyeva N.V., Belov B.S. Comorbid Infections in Rheumatoid Arthritis: Frequency, Structure, Prevention. In: Pokrovskiy V.I. (ed.). Infectious Diseases in the Modern World: Epidemiology, Diagnosis, Treatment and Prevention: Proceedings of the XII Annual All-Russian Internet Congress on Infectious Diseases with International Participation. Moscow: Meditsinskoye marketingovoye agentstvo; 2020, p. 131. (In Russ.).

10. Belov B.S., Muravyeva N.V., Tarasova G.M., Baranova M.M. Use of Janus Kinase Inhibitors in the Treatment of Immunoinflammatory Rheumatic Diseases: Safety Issues. Meditsinskiy sovet = Medical Council. 2021;(2): 76-84. (In Russ.) https://doi.org/10.21518/2079-701X-2021-2-76-84.

11. Furer V., Rondaan C., Heijstek M., van Assen S., Bijl M., Agmon-Levin N. et al. Incidence and Prevalence of Vaccine Preventable Infections in Adult Patients with Autoimmune Inflammatory Rheumatic Diseases (AIIRD): A Systemic Literature Review Informing the 2019 Update of the EULAR Recommendations for Vaccination in Adult Patients with AIIRD. RMD Open. 2019;5(2):e001041. https://doi.org/10.1136/rmdopen-2019-001041.

12. Furer V., Rondaan C., Heijstek M.W., Agmon-Levin N., van Assen S., Bijl M. et al. 2019 Update of EULAR Recommendations for Vaccination in Adult Patients with Autoimmune Inflammatory Rheumatic Diseases. Ann Rheum Dis. 2020;79(1):39-52. https://doi.org/10.1136/annrheumdis-2019-215882.

13. Fischer L., Gerstel P.F., Poncet A., Siegrist C.A., Laffitte E., Gabay C. et al. Pneumococcal Polysaccharide Vaccination in Adults Undergoing Immunosuppressive Treatment for Inflammatory Diseases - A Longitudinal Study. Arthritis Res Ther. 2015;17(1):151. https://doi.org/10.1186/s13075-015-0663-9.

14. Kapetanovic M.C., Saxne T., Sjoholm A., Truedsson L., Jonsson G., Geborek P Influence of Methotrexate, TNF Blockers and Prednisolone on Antibody Responses to Pneumococcal Polysaccharide Vaccine in Patients with Rheumatoid Arthritis. Rheumatology (Oxford). 2006;45(1):106-111. https://doi.org/10.1093/rheumatology/kei193.

15. Kapetanovic M.C., Roseman C., Jonsson G., Truedsson L. Heptavalent Pneumococcal Conjugate Vaccine Elicits Similar Antibody Response as Standard 23-Valent Polysaccharide Vaccine in Adult Patients with RA Treated with Immunomodulating Drugs. Clin Rheumatol. 2011;30(12):1555-1561. https://doi.org/10.1007/s10067-011-1856-5.

16. Rasmussen S.L., Fuursted K., Nielsen K.A., Laurberg N.P., Sorensen M.B., Fagerberg S.K. et al. Pneumococcal Antibody Protection in Patients with Autoimmune Inflammatory Rheumatic Diseases with Varying Vaccination Status. ScandJ Rheumatol. 2020;49(5):353-360. https://doi.org/10.1080/03009742.2020.1732459.

17. Kaine J.L., Kivitz AJ., Birbara C., Luo A.Y. Immune Responses Following Administration of Influenza and Pneumococcal Vaccines to Patients with Rheumatoid Arthritis Receiving Adalimumab. J Rheumatol. 2007;34(2):272-279. Available at: https://www.jrheum.org/content/34/2/272.long.

18. Elkayam O., Caspi D., Reitblatt T., Charboneau D., Rubins J.B. The Effect of Tumor Necrosis Factor Blockade on the Response to Pneumococcal Vaccination in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. Semin Arthritis Rheum. 2004;33(4):283-288. https://doi.org/10.1053/j.semarthrit.2003.10.003.

19. Kivitz AJ., Schechtman J., Texter M., Fichtner A., de Longueville M., Chartash E.K. Vaccine Responses in Patients with Rheumatoid Arthritis Treated with Certolizumab Pegol: Results from a Single-Blind Randomized Phase IV Trial. J Rheumatol. 2014;41(4):648-657. https://doi.org/10.3899/jrheum.130945.

20. Guerrini G., Franzetti F., Giacomelli R., Meroni L., Riva A., Scire C.A. et al. Italian Recommendations for Influenza and Pneumococcal Vaccination in Adult Patients with Autoimmune Rheumatic Diseases. Clin Exp Rheumatol. 2020;38(2):245-256. Available at: https://www.clinexprheuma-tol.org/abstract.asp?a=14029.

21. Buhler S., Eperon G., Ribi C., Kyburz D., van Gompel F., Visser L.G. et al. Vaccination Recommendations for Adult Patients with Autoimmune Inflammatory Rheumatic Diseases. Swiss Med Wkly. 2015;145:w14159. https://doi.org/10.4414/smw.2015.14159.

22. Izumi Y., Akazawa M., Akeda Y., Tohma S., Hirano F., Ideguchi H. et al. The 23-Valent Pneumococcal Polysaccharide Vaccine in Patients with Rheumatoid Arthritis: A Double-Blinded, Randomized, Placebo-Controlled Trial. Arthritis Res Ther. 2017;19(1):15. https://doi.org/10.1186/s13075-016-1207-7.


Review

For citations:


Baranova MM, Sergeeva MS, Muravyeva NV, Belov BS. Immunogenicity, safety and efficacy of 23-valent pneumococcal polysaccharide vaccine in patients with inflammatory joint diseases (preliminary data). Meditsinskiy sovet = Medical Council. 2021;(10):172-177. (In Russ.) https://doi.org/10.21518/2079-701X-2021-10-172-177

Views: 443


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)