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Published in: Modern Rheumatology 6/2012

01-11-2012 | Original Article

Safety and response to influenza vaccine in patients with systemic-onset juvenile idiopathic arthritis receiving tocilizumab

Authors: Toshihiko Shinoki, Ryoki Hara, Utako Kaneko, Takako Miyamae, Tomoyuki Imagawa, Masaaki Mori, Shumpei Yokota

Published in: Modern Rheumatology | Issue 6/2012

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Abstract

Objective

We investigated the safety and efficacy of administering influenza vaccines to patients with systemic-onset juvenile idiopathic arthritis (sJIA) treated with tocilizumab.

Patients and methods

The subjects were 27 sJIA patients treated with tocilizumab and 17 healthy age- and sex-matched volunteers. Serum samples were collected prior to and 4–7 weeks after vaccination. Hemagglutination inhibition values of the vaccine were taken as the antibody titers. The duration of tocilizumab administration and the daily doses of prednisolone per unit body weight were analyzed to identify factors affecting the responses of the sJIA patients to influenza vaccination. We questioned all the subjects about whether they had contracted influenza and whether they had had adverse reactions to the influenza vaccination. We compared steroid doses in sJIA patients before and after vaccination to document any worsening of the underlying disease.

Results

The efficacy of influenza vaccination did not differ significantly between the sJIA group and the healthy controls. The duration of tocilizumab administration did not affect the response of the sJIA patients to the influenza vaccination. None of the sJIA patients experienced either severe adverse reactions or disease exacerbation after the influenza vaccination.

Conclusion

We found that sJIA patients treated with tocilizumab could be effectively and safely immunized with the influenza vaccine.
Literature
1.
go back to reference Kanakoudi-Tsakalidou F, Trachana M, Pratsidou-Gertsi P, Tsitsami E, Kyriazopoulou-Dalaina V. Influenza vaccination in children with chronic rheumatic diseases and long-term immunosuppressive therapy. Clin Exp Rheumatol. 2001;19(5):589–94.PubMed Kanakoudi-Tsakalidou F, Trachana M, Pratsidou-Gertsi P, Tsitsami E, Kyriazopoulou-Dalaina V. Influenza vaccination in children with chronic rheumatic diseases and long-term immunosuppressive therapy. Clin Exp Rheumatol. 2001;19(5):589–94.PubMed
2.
go back to reference Yokota S, Imagawa T, Mori M, et al. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled, withdrawal phase III trial. Lancet. 2008;371(9617):998–1006.PubMedCrossRef Yokota S, Imagawa T, Mori M, et al. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled, withdrawal phase III trial. Lancet. 2008;371(9617):998–1006.PubMedCrossRef
3.
go back to reference Hirano T, Yasukawa K, Harada H, et al. Complementary DNA for a novel human interleukin (BSF-2) that induces B lymphocytes to produce immunoglobulin. Nature. 1986;324(6092):73–6.PubMedCrossRef Hirano T, Yasukawa K, Harada H, et al. Complementary DNA for a novel human interleukin (BSF-2) that induces B lymphocytes to produce immunoglobulin. Nature. 1986;324(6092):73–6.PubMedCrossRef
4.
go back to reference Yoshizaki K, Nakagawa T, Fukunaga K, Tseng LT, Yamamura Y, Kishimoto T. Isolation and characterization of B cell differentiation factor (BCDF) secreted from a human B lymphoblastoid cell line. J Immunol. 1984;132(6):2948–54.PubMed Yoshizaki K, Nakagawa T, Fukunaga K, Tseng LT, Yamamura Y, Kishimoto T. Isolation and characterization of B cell differentiation factor (BCDF) secreted from a human B lymphoblastoid cell line. J Immunol. 1984;132(6):2948–54.PubMed
5.
go back to reference International League of Associations for Rheumatology. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2. International League of Associations for Rheumatology. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2.
6.
go back to reference Belshe RB, Newman FK, Cannon J, et al. Serum antibody responses after intradermal vaccination against influenza. N Engl J Med. 2004;351(22):2286–94.PubMedCrossRef Belshe RB, Newman FK, Cannon J, et al. Serum antibody responses after intradermal vaccination against influenza. N Engl J Med. 2004;351(22):2286–94.PubMedCrossRef
7.
go back to reference Gelinck LB, van der Bijl AE, Beyer WE, et al. The effect of anti-tumour necrosis factor alpha treatment on the antibody response to influenza vaccination. Ann Rheum Dis. 2008;67(5):713–6.PubMedCrossRef Gelinck LB, van der Bijl AE, Beyer WE, et al. The effect of anti-tumour necrosis factor alpha treatment on the antibody response to influenza vaccination. Ann Rheum Dis. 2008;67(5):713–6.PubMedCrossRef
8.
go back to reference Kawai N, Ikematsu H, Iwaki N, et al. Analysis of the incidence of influenza, the response of influenza vaccination and the effectiveness of anti-influenza drugs in the 2007-2008 winter season in Japan (in Japanese). Japan Med J 2008;4416:70–5. Kawai N, Ikematsu H, Iwaki N, et al. Analysis of the incidence of influenza, the response of influenza vaccination and the effectiveness of anti-influenza drugs in the 2007-2008 winter season in Japan (in Japanese). Japan Med J 2008;4416:70–5.
9.
go back to reference Aikawa NE, Campos LM, Silva CA, et al. Glucocorticoid: major factor for reduced immunogenicity of 2009 influenza A (H1N1) vaccine in patients with juvenile autoimmune rheumatic disease. J Rheumatol 2011;39:167–73. doi:10.3899/jrheum.110721. Aikawa NE, Campos LM, Silva CA, et al. Glucocorticoid: major factor for reduced immunogenicity of 2009 influenza A (H1N1) vaccine in patients with juvenile autoimmune rheumatic disease. J Rheumatol 2011;39:167–73. doi:10.​3899/​jrheum.​110721.
10.
go back to reference Wallin L, Quintilio W, Locatelli F, et al. Safety and efficiency of influenza vaccination in systemic lupus erythematosus patients. Acta Reumatol Port. 2009;34:498–502.PubMed Wallin L, Quintilio W, Locatelli F, et al. Safety and efficiency of influenza vaccination in systemic lupus erythematosus patients. Acta Reumatol Port. 2009;34:498–502.PubMed
11.
go back to reference Kaine JL, Kivitz AJ, Birbara C, Luo AY. Immune responses following administration of influenza and pneumococcal vaccines to patients with rheumatoid arthritis receiving adalimumab. J Rheumatol. 2007;34(2):272–9.PubMed Kaine JL, Kivitz AJ, Birbara C, Luo AY. Immune responses following administration of influenza and pneumococcal vaccines to patients with rheumatoid arthritis receiving adalimumab. J Rheumatol. 2007;34(2):272–9.PubMed
12.
go back to reference Kapetanovic MC, Saxne T, Nilsson JA, Geborek P. Influenza vaccination as model for testing immune modulation induced by anti-TNF and methotrexate therapy in rheumatoid arthritis patients. Rheumatology (Oxford). 2007;46(4):608–11.CrossRef Kapetanovic MC, Saxne T, Nilsson JA, Geborek P. Influenza vaccination as model for testing immune modulation induced by anti-TNF and methotrexate therapy in rheumatoid arthritis patients. Rheumatology (Oxford). 2007;46(4):608–11.CrossRef
13.
go back to reference Kubota T, Nii T, Nanki T, Kohsaka H, et al. Anti-tumor necrosis factor therapy does not diminish the immune response to influenza vaccine in Japanese patients with rheumatoid arthritis. Mod Rheumatol. 2007;17(6):531–3.PubMedCrossRef Kubota T, Nii T, Nanki T, Kohsaka H, et al. Anti-tumor necrosis factor therapy does not diminish the immune response to influenza vaccine in Japanese patients with rheumatoid arthritis. Mod Rheumatol. 2007;17(6):531–3.PubMedCrossRef
14.
go back to reference Fomin I, Caspi D, Levy V, et al. Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying drugs, including TNF alpha blockers. Ann Rheum Dis. 2006;65(2):191–4.PubMedCrossRef Fomin I, Caspi D, Levy V, et al. Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying drugs, including TNF alpha blockers. Ann Rheum Dis. 2006;65(2):191–4.PubMedCrossRef
15.
go back to reference Salemi S, Picchianti-Diamanti A, Germano V, et al. Influenza vaccine administration in rheumatoid arthritis patients under treatment with TNFalpha blockers: safety and immunogenicity. Clin Immunol. 2010;134(2):113–20.PubMedCrossRef Salemi S, Picchianti-Diamanti A, Germano V, et al. Influenza vaccine administration in rheumatoid arthritis patients under treatment with TNFalpha blockers: safety and immunogenicity. Clin Immunol. 2010;134(2):113–20.PubMedCrossRef
16.
go back to reference Elkayam O, Bashkin A, Mandelboim M, et al. The effect of infliximab and timing of vaccination on the humoral response to influenza vaccination in patients with rheumatoid arthritis and ankylosing spondylitis. Semin Arthritis Rheum. 2010;39(6):442–7.PubMedCrossRef Elkayam O, Bashkin A, Mandelboim M, et al. The effect of infliximab and timing of vaccination on the humoral response to influenza vaccination in patients with rheumatoid arthritis and ankylosing spondylitis. Semin Arthritis Rheum. 2010;39(6):442–7.PubMedCrossRef
17.
go back to reference Shale M, Czub M, Kaplan GG, Panaccione R, Ghosh S. Anti-tumor necrosis factor therapy and influenza: keeping it in perspective. Therap Adv Gastroenterol. 2010;3(3):173–7.PubMedCrossRef Shale M, Czub M, Kaplan GG, Panaccione R, Ghosh S. Anti-tumor necrosis factor therapy and influenza: keeping it in perspective. Therap Adv Gastroenterol. 2010;3(3):173–7.PubMedCrossRef
18.
go back to reference Muhammad K, Roll P, Seibold T, et al. Impact of IL-6 receptor inhibition on human memory B cells in vivo: impaired somatic hypermutation in preswitch memory B cells and modulation of mutational targeting in memory B cells. Ann Rheum Dis. 2011;70:1507–10.PubMedCrossRef Muhammad K, Roll P, Seibold T, et al. Impact of IL-6 receptor inhibition on human memory B cells in vivo: impaired somatic hypermutation in preswitch memory B cells and modulation of mutational targeting in memory B cells. Ann Rheum Dis. 2011;70:1507–10.PubMedCrossRef
19.
go back to reference Roll P, Muhammad K, Schumann M, et al. In vivo effects of the anti-interleukin-6 receptor inhibitor tocilizumab on the B cell compartment. Arthritis Rheum. 2011;63:1255–64.PubMedCrossRef Roll P, Muhammad K, Schumann M, et al. In vivo effects of the anti-interleukin-6 receptor inhibitor tocilizumab on the B cell compartment. Arthritis Rheum. 2011;63:1255–64.PubMedCrossRef
Metadata
Title
Safety and response to influenza vaccine in patients with systemic-onset juvenile idiopathic arthritis receiving tocilizumab
Authors
Toshihiko Shinoki
Ryoki Hara
Utako Kaneko
Takako Miyamae
Tomoyuki Imagawa
Masaaki Mori
Shumpei Yokota
Publication date
01-11-2012
Publisher
Springer Japan
Published in
Modern Rheumatology / Issue 6/2012
Print ISSN: 1439-7595
Electronic ISSN: 1439-7609
DOI
https://doi.org/10.1007/s10165-012-0595-z

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