The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Humoral responses after influenza vaccination are severely reduced in patients with rheumatoid arthritis treated with rituximab
Abstract
Objective: For patients with rheumatoid arthritis (RA), yearly influenza vaccination is recommended. However, its efficacy in patients treated with rituximab is unknown. The objectives of this study were to investigate the efficacy of influenza vaccination in RA patients treated with rituximab and to investigate the duration of the possible suppression of the humoral immune response following rituximab treatment. We also undertook to assess the safety of influenza vaccination and the effects of previous influenza vaccination. Methods: Trivalent influenza subunit vaccine was administered to 23 RA patients who had received rituximab (4–8 weeks after rituximab for 11 patients [the early rituximab subgroup] and 6–10 months after rituximab for 12 patients [the late rituximab subgroup]), 20 RA patients receiving methotrexate (MTX), and 29 healthy controls. Levels of antibodies against the 3 vaccine strains were measured before and 28 days after vaccination using hemagglutination inhibition assay. The Disease Activity Score in 28 joints (DAS28) was used to assess RA activity. Results: Following vaccination, geometric mean titers (GMTs) of antiinfluenza antibodies significantly increased for all influenza strains in the MTX‐treated group and in healthy controls, but for no strains in the rituximab‐treated group. However, in the late rituximab subgroup, a rise in GMT for the A/H3N2 and A/H1N1 strains was demonstrated, in the absence of a repopulation of CD19+ cells at the time of vaccination. Seroconversion and seroprotection occurred less often in the rituximab‐treated group than in the MTX‐treated group for the A/H3N2 and A/H1N1 strains, while seroprotection occurred less often in the rituximab‐treated group than in the healthy controls for the A/H1N1 strain. Compared with unvaccinated patients in the rituximab‐treated group, previously vaccinated patients in the rituximab‐treated group had higher pre‐ and postvaccination GMTs for the A/H1N1 strain. The DAS28 did not change after vaccination. Conclusion: Rituximab reduces humoral responses following influenza vaccination in RA patients, with a modestly restored response 6–10 months after rituximab administration. Previous influenza vaccination in rituximab‐treated patients increases pre‐ and postvaccination titers. RA activity was not influenced.
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“Our findings are in line with the previously published data regarding the negative impact of anti-CD20 therapy on the humoral response to various vaccines, although seroprotection could be still achieved after vaccination in rituximab-treated 20 26 34-36 and ocrelizumab-treated 37 patients.”
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Pawlitzki, M., Zettl, U. K., Ruck, T., Rolfes, L., Hartung, H., & Meuth, S. G. (2020) · DGNeurologie · doi:10.1007/s42451-020-00205-6 · Cited by 1
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Bansal, P., & Goyal, A. (2020) · General Internal Medicine and Clinical Innovations · doi:10.15761/gimci.1000196 · Cited by 1
“Studies in the past have shown reduced humoral response to seasonal influenza and pneumococcal vaccines due to methotrexate, rituximab and abatacept, and to Hepatitis B vaccine in patients taking tumor-necrosis factor inhibitors [14-21].”
BackgroundChapter 71 – Treatment of Rheumatoid Arthritis
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SARS-COV-2 Vaccine Responses in Renal Patient PopulationsPreprint
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“Ein Sonderfall besteht bei anstehender B-Zell-depletierender Therapie, da nach entsprechender Therapie oft bis zu sechs Monate nach der Therapie das Impf ansprechen deutlich eingeschränkt sein kann (13): • Falls die Grunderkrankung dies zulässt, sollten sämtliche erforderlichen Impfungen mit einem Mindestabstand zur B…”
BackgroundAUTOIMUNINĖS UŽDEGIMINĖS REUMATINĖS LIGOS IR SKIEPIJIMO TIKSLINGUMAS
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Determinants of disease severity in primary Sjögren’s syndrome
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Self-citationCividino, A. A. (2013) · Canadian Journal of General Internal Medicine · doi:10.22374/cjgim.v8i0.103
Cell-Targeted Biologics and Emerging Targets
Taylor, P. C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-31696-5.00064-4
Complicaties van behandeling met biologicals
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Bacterial and Fungal Infections in Rheumatoid Arthritis
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“Данная вакцина была иммуногенной у больных РА, СКВ, ААВ, ССД и ПсА при лечении противовоспалительными препаратами всех классов, исключая РТМ [18, 19].”
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Vaccination of Geriatric Population with Rheumatic Conditions
Paz, A. (2020) · Springer eBooks · doi:10.1007/978-3-030-44234-7_9
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Features of the course of influenza in some categories of neurological patients
Demianovskaya, E. G., & Vasiliev, A. S. (2021) · Лечащий врач · doi:10.51793/os.2021.24.3.011
Talari, K., Ravindran, V. K., Kumar, P., Patil, P., Veeravalli, S. C. M., Bandyopadhyay, S., Dharmanand, B. G., Ray, A., Rajeshwari, S., Amin, S. N., et al. (2021) · Indian Journal of Rheumatology · doi:10.4103/injr.injr_69_21
“[38,39] The effect on HBV and other vaccines is not known.”
Immunosuppressive therapy in SLE
Wise, L. M., & Stohl, W. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-820583-9.00044-0
Popescu, R. Ș., Săndulescu, O., Streinu-Cercel, A., Balanescu, A. R., Ionescu, R. M., & Streinu‐Cercel, A. (2017) · Romanian Journal of Rheumatology · doi:10.37897/rjr.2017.1.3
Treatment of Secondary Immunodeficiencies
Schweitzer, L., Korsos, V., & Vinh, D. C. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818731-9.00175-0
Anti-inflammatory drugs and immunogenicity of vaccines in patients with rheumatic diseases
Belov, B. S., Muravyevа, N. V., & Баранова, М. М. (2021) · Meditsinskiy sovet = Medical Council · doi:10.21518/2079-701x-2021-19-177-187
Current aspects of vaccination of children with rheumatic diseases (reference review)
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“[13,24] It stems from the belief that the effects of RTX lasts for 6 months and immune responses will be blunted until then.”
Consenso de inmunizaciones en adultos con enfermedades reumáticas inflamatorias crónicas autoinmunes
Bonvehí, P., Cosentino, V. L., Jordán, R., Larroudé, M. S., Nacinovich, F., Rossi, I. R., Schneeberger, E. E., Stecher, D., Valledor, A., Vázquez, H., et al. (2022) · Revista Argentina de Reumatología · doi:10.47196/rar.v33i1sup.615
Lluch, M., Vega, B. P., Becerra, M. C., Rodríguez, Á., Escalera-Zalvide, A., & Sánchez, S. Á. (2022) · Revista Española de Quimioterapia · doi:10.37201/req/122.2021
“Diversos estudios ya mostraron esta respuesta atenuada a la vacuna contra la influenza en pacientes tratados con rituximab [11].”
Monoclonal anti-CD20 antibodies in lymphomas therapy during the COVID-19 pandemic: pro and contra
Sychevskaya, K. A., & Кравченко, С. К. (2022) · Oncohematology · doi:10.17650/1818-8346-2022-17-2-95-106
Fernández, A. G., Morán‐Álvarez, P., Bachiller‐Corral, J., & Díaz, M. V. (2022) · JCR Journal of Clinical Rheumatology · doi:10.1097/rhu.0000000000001876
“A lower IgG response has been previously described after influenza and pneumococcal vaccination in patients with RA.2 Retrospective studies have reported a higher infection rate in RA patients treated with rituximab compared with other biologics such as abatacept or tocilizumab.3 Whether patients with RMD have a highe…”
ResultAlmutairi, L., Alalayet, W. Y., Ata, S. I., Alenzi, K. A. O., & AlRuthia, Y. S. (2022) · Vaccines · doi:10.3390/vaccines10060977
Infections Related to Biologic Response Modifying Drug Therapy
Davies, H. D. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-75608-2.00107-5
Safety and Efficacy of Vaccines in Patients on Targeted and Biologic Therapies
Sonpar, A. (2022) · Springer eBooks · doi:10.1007/978-3-031-11363-5_3
Safety of B-Cell Targeted Therapies
Bruce, I. N. (2013) · Milestones in drug therapy · doi:10.1007/978-3-0348-0706-7_14
Vacinação em pacientes usuários de imunobiológicos
Saad, C. G. S., & Aikawa, N. E. (2017) · Revista Paulista de Reumatologia · doi:10.46833/reumatologiasp.2017.16.1.10-15
Management of Immunosuppressed Dermatology Patients During COVID-19
Pham, J. P., & Frew, J. W. (2023) · Updates in clinical dermatology · doi:10.1007/978-3-031-45586-5_11
Lyou, H. J., & Lee, H. L. (2023) · Journal of Multiple Sclerosis and Neuroimmunology · doi:10.59578/jmsni.14.2.73
Tan, A. J., Archila, M., Barbieri, J. S., Mostaghimi, A., Scherer, A. M., Perez-Chada, L. M., Asgari, M. M., Gelfand, J. M., & Noe, M. H. (2024) · Archives of Dermatological Research · doi:10.1007/s00403-024-02862-z
Vaccinations in Patients with Systemic Sclerosis
Bernstein, E. J., & Pauling, J. D. (2024) · Springer eBooks · doi:10.1007/978-3-031-40658-4_40
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Metadata
- Authors
- van Assen, S., Holvast, A., Benne, C. A., Posthumus, M. D., van Leeuwen, M. A., Voskuyl, A. E., Blom, M., Risselada, A. P., de Haan, A., Westra, J., Kallenberg, C. G. M., & Bijl, M.
- Affiliations
- University Medical Center Groningen (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Radboud University Nijmegen (NL)
- University Medical Center Utrecht (NL)
- Venue
- Arthritis & Rheumatism
- Publisher
- Wiley
- Published
- 2009-12-28
- Volume
- 62
- Issue
- 1
- Pages
- 75-81
- ISSN
- 0004-3591 (ISSN-L)
- 1529-0131
- OpenAlex
- W2059903231
- Cited by
- 371
- References
- 18
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 21 · 2023: 20 · 2022: 35 · 2021: 57 · 2020: 30 · 2019: 11 · 2018: 17 · 2017: 14 · 2016: 14 · 2015: 20 · 2014: 23 · 2013: 24 · 2012: 15
- FWCI
- 15.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis & Rheumatism (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- rheumatoid arthritis, rituximab, influenza vaccination, humoral immune response, influenza antibodies, seroprotection, seroconversion, methotrexate, CD19+ B cells, vaccine efficacy, disease activity, trivalent influenza vaccine, B-cell depletion, hemagglutination inhibition test, DAS28
- MeSH terms
- Rituximab, Antibodies, Monoclonal, Antibodies, Viral, Arthritis, Rheumatoid, Drug Therapy, Combination, Female, Hemagglutination Inhibition Tests, Humans, Immunization Schedule, Immunologic Memory, Influenza Vaccines, Male, Methotrexate, Middle Aged, Vaccines, Inactivated, B-Lymphocyte Subsets, Antirheumatic Agents, Antigens, CD20, Immunity, Humoral, Antibodies, Monoclonal, Murine-Derived
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