Safety and immunogenicity of tetanus/diphtheria vaccination in patients with rheumatic diseases-a prospective multi-centre cohort study
| العنوان: | Safety and immunogenicity of tetanus/diphtheria vaccination in patients with rheumatic diseases-a prospective multi-centre cohort study |
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| المؤلفون: | Bettina Bannert, Michael John Nissen, Silja Bühler, Claire-Anne Siegrist, Ulrich A. Walker, Carolin Brümmerhoff, Kerstin Kling, Christian Herzog, Adrian Ciurea, Veronika K. Jaeger, Niels Hagenbuch, Diego Kyburz, Rüdiger Müller, Oliver Distler, Cem Gabay, Peter M. Villiger, Christoph Hatz, Paul Hasler, Juliane Franz, Sabine Adler |
| المساهمون: | University of Zurich, Bühler, Silja |
| المصدر: | Rheumatology, Vol. 58, No 9 (2019) pp. 1585-1596 |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Diphtheria-Tetanus Vaccine, 2745 Rheumatology, Booster dose, 0302 clinical medicine, Immunogenicity, Vaccine, 2736 Pharmacology (medical), Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, ddc:616, Aged, 80 and over, Tetanus, Immunogenicity, Vaccination, 10051 Rheumatology Clinic and Institute of Physical Medicine, Diphtheria, Middle Aged, Antibodies, Bacterial, 3. Good health, Tetanus vaccine, Female, Safety, Vasculitis, Immunosuppressive Agents, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Immunization, Secondary, Tetanus vaccination, 610 Medicine & health, Diphtheria vaccination, complex mixtures, 03 medical and health sciences, Young Adult, Rheumatology, Internal medicine, Clostridium tetani, Rheumatic Diseases, medicine, Humans, Aged, 030203 arthritis & rheumatology, business.industry, Corynebacterium diphtheriae, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), medicine.disease, Rheumatic disease, business, Immunosuppression |
| الوصف: | Objectives We aimed to assess the safety and immunogenicity of a diphtheria/tetanus vaccine booster dose in three different patient groups with rheumatic diseases on a variety of immunosuppressive/immunomodulatory medications compared with healthy controls (HCs). Methods We conducted a multi-centre prospective cohort study in Switzerland. We enrolled patients with RA, axial SpA/PsA, vasculitis (Behçet’s disease, ANCA-associated vasculitis) and HCs. Diphtheria/tetanus vaccination was administered according to the Swiss vaccination recommendations. Blood samples were drawn before vaccination, and 1 month and 3 months afterwards. Antibody concentrations against vaccine antigens were measured by ELISA. Immunogenicity was compared between patient and medication groups. A mixed model was applied for multivariate analysis. Missing data were dealt with using multiple imputation. Results Between January 2014 and December 2015, we enrolled 284 patients with rheumatic diseases (131 RA, 114 SpA/PsA, 39 vasculitis) and 253 HCs. Of the patients, 89% were on immunosuppressive/immunomodulatory medication. Three months post-vaccination 100% of HCs vs 98% of patients were protected against tetanus and 84% vs 73% against diphtheria. HCs and SpA/PsA patients had significantly higher responses than RA and vasculitis patients. Assessing underlying diseases and medications in a multivariate model, rituximab was the only factor negatively influencing tetanus immunogenicity, whereas only MTX treatment had a negative influence on diphtheria antibody responses. No vaccine-related serious adverse events were recorded. Conclusion Diphtheria/tetanus booster vaccination was safe. Tetanus vaccination was immunogenic; the diphtheria component was less immunogenic. Vaccine responses were blunted by rituximab and MTX. Trial registration ClinicalTrials.gov, http://clinicaltrials.govTest, Identifier: NCT01947465. |
| وصف الملف: | ZORA_170630.pdf - application/pdf |
| تدمد: | 1462-0332 1462-0324 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ae0267135d836b3d122999fe1935525bTest https://pubmed.ncbi.nlm.nih.gov/30877773Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....ae0267135d836b3d122999fe1935525b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14620332 14620324 |
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