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Hepatitis B vaccination associated with low response in patients with rheumatic diseases treated with biologics.
Romão, Vasco C; Ávila-Ribeiro, Pedro; Gonçalves, Maria João; Cruz-Machado, Rita; Guerreiro, André Bento; Teixeira, Vítor; Valido, Ana; Silva-Dinis, Joana; Vieira-Sousa, Elsa; Saavedra, Maria João; Sacadura-Leite, Ema; Marinho, Rui Tato; Fonseca, João Eurico.
Afiliación
  • Romão VC; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Ávila-Ribeiro P; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
  • Gonçalves MJ; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal pedro.ribeiro@medicina.ulisboa.pt.
  • Cruz-Machado R; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
  • Guerreiro AB; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Teixeira V; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
  • Valido A; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Silva-Dinis J; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
  • Vieira-Sousa E; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
  • Saavedra MJ; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Sacadura-Leite E; Serviço de Reumatologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
  • Marinho RT; Serviço de Reumatologia e Doenças Ósseas Metabólicas, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Fonseca JE; Unidade de Investigação em Reumatologia, Universidade de Lisboa Instituto de Medicina Molecular João Lobo Antunes, Lisboa, Portugal.
RMD Open ; 9(4)2023 12 06.
Article en En | MEDLINE | ID: mdl-38056920
BACKGROUND: Hepatitis B virus (HBV) vaccination is recommended for non-immunised patients with rheumatic diseases starting biological disease-modifying antirheumatic drugs (bDMARDs). There is some evidence that HBV vaccination is effective in patients under conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), but it is currently unclear whether this also applies to bDMARDs. OBJECTIVES: To assess the efficacy and safety of HBV vaccination in patients with inflammatory arthritides treated with bDMARDs. METHODS: A prospective cohort with inflammatory arthritides treated with bDMARDs, negative for anti-HBs and anti-HBc and never vaccinated for HBV was recruited. Engerix B was administered at 0, 1 and 6 months and anti-HBs was reassessed ≥1 month after last dose. Response was defined as anti-HBs≥10 IU/L and compared against vaccinated healthy controls. Disease flare, serious adverse events and immune-related disorders not previously present were recorded. RESULTS: 62 patients, most treated with TNF inhibitors (TNFi), and 38 controls were recruited. Most patients were taking csDMARDs (67.7%) and were in remission/low disease activity (59.4%). Only 20/62 patients (32.3%) had a positive response to vaccination, in comparison to 36/38 age-matched controls (94.7%, p<0.001). Response was seen in 19/51 patients treated with TNFi (37.3%) and in 1/11 (9.1%) patients treated with non-TNFi (p=0.07), including 1/6 treated with tocilizumab (16.7%). Among TNFi, response rates ranged from 4/22 (18.2%) for infliximab to 8/14 (57.1%) for etanercept. No relevant safety issues were identified. CONCLUSIONS: HBV vaccination response in patients with rheumatic diseases treated with bDMARDs was poorer than expected. Our data reinforce the recommendation for vaccination prior to starting bDMARDs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis / Productos Biológicos / Enfermedades Reumáticas / Antirreumáticos / Hepatitis B Límite: Humans Idioma: En Revista: RMD Open Año: 2023 Tipo del documento: Article País de afiliación: Portugal Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis / Productos Biológicos / Enfermedades Reumáticas / Antirreumáticos / Hepatitis B Límite: Humans Idioma: En Revista: RMD Open Año: 2023 Tipo del documento: Article País de afiliación: Portugal Pais de publicación: Reino Unido