Evaluation of the immune response to hepatitis B vaccine in patients on biological therapy: results of the RIER cohort study.
Anti-TNF
Biological therapy
Hepatitis B virus
Rituximab
Vaccination
Journal
Clinical rheumatology
ISSN: 1434-9949
Titre abrégé: Clin Rheumatol
Pays: Germany
ID NLM: 8211469
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
05
11
2019
accepted:
10
03
2020
revised:
12
02
2020
pubmed:
6
4
2020
medline:
15
5
2021
entrez:
6
4
2020
Statut:
ppublish
Résumé
To evaluate the response to hepatitis B virus (HBV) vaccine in patients on biological therapy. Adults with autoimmune inflammatory diseases on biological therapy such as anti-TNFα, rituximab, tocilizumab, abatacept, or anakinra were included. Hepatitis B surface antibody (anti-HBs) was measured by ELISA before and after vaccination. Seroconversion was considered when an anti-HBs titer > 10 mIU/mL was achieved. The effect of treatment on the immunoprotective state was studied. The response was compared with that obtained in patients on synthetic disease modifying anti-rheumatic drugs (DMARDs) and healthy controls. A total of 187 patients on biologicals, 48 on synthetic DMARDs, and 49 on healthy controls were analyzed. More than 80% of patients on biologics responded to the vaccine but required more boosters and second vaccine series. Patients who achieved seroconversion were younger than those who did not (47.10 ± 12.99 vs. 53.18 ± 10.54 years, p = 0.012). Being on etanercept or golimumab was associated with seroconversion, while being on rituximab was not. Seroconversion was achieved in 93.75% of patients on synthetic DMARDs and 97.96% of healthy controls. The seroconversion rate in the biologics group was lower than in the synthetic DMARD group (p = 0.043) and tended to be lower than in the healthy group (p = 0.056). In patients on biological therapy, a high rate of HBV vaccine response can be achieved when a complete vaccination schedule is administered. Vaccination while not on biological agents reduces the requirement for boosters and revaccination. Key points: • Patients on biological therapy can achieve high rates of immune response to HBV vaccine when complete vaccination schedules are administered. • However, to achieve such a high seroconversion rate, more boosters and second vaccination series are required. • This supports the proposal already made to provide HBV vaccination to all patients with an autoimmune inflammatory disease after the diagnosis is made and not when the use of a biological treatment is under consideration.
Identifiants
pubmed: 32248433
doi: 10.1007/s10067-020-05042-2
pii: 10.1007/s10067-020-05042-2
doi:
Substances chimiques
Hepatitis B Antibodies
0
Hepatitis B Surface Antigens
0
Hepatitis B Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2751-2756Subventions
Organisme : Sociedad de Reumatología Comunidad de Madrid (SORCOM)/MSD
ID : 20141
Organisme : Pfizer
ID : NA
Références
Elkayam O, Yaron M, Caspi D (2002) Safety and efficacy of vaccination against hepatitis B in patients with rheumatoid arthritis. Ann Rheum Dis 61:623–625
doi: 10.1136/ard.61.7.623
Furer V, Rondaan C, Heijstek MW, Agmon-Levin N, van Assen S, Bijl M et al (2019) 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis. https://doi.org/10.1136/annrheumdis-2019-215882
Singh JA, Saag KG, Bridges SL, Akl EA, Bannuru RR, Sullivan MC et al (2016) 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis: ACR RA treatment recommendations. Arthritis Care Res 68:1–25
doi: 10.1002/acr.22783
Pratt PK, David N, Weber HC, Little FF, Kourkoumpetis T, Patts GJ, Weinberg J, Farraye FA (2018) Antibody response to hepatitis B virus vaccine is impaired in patients with inflammatory bowel disease on infliximab therapy. Inflamm Bowel Dis 24:380–386
doi: 10.1093/ibd/izx001
Rahier JF, Magro F, Abreu C, Armuzzi A, Ben-Horin S, Chowers Y, Cottone M, de Ridder L, Doherty G, Ehehalt R, Esteve M, Katsanos K, Lees CW, Macmahon E, Moreels T, Reinisch W, Tilg H, Tremblay L, Veereman-Wauters G, Viget N, Yazdanpanah Y, Eliakim R, Colombel JF, European Crohn’s and Colitis Organisation (ECCO) (2014) Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis 8:443–468
doi: 10.1016/j.crohns.2013.12.013
Intongkam S, Samakarnthai P, Pakchotanon R, Narongroeknawin P, Assavatanabodee P, Chaiamnuay S (2018) Efficacy and safety of hepatitis B vaccination in rheumatoid arthritis patients receiving disease-modifying antirheumatic drugs and/or biologics therapy. J Clin Rheumatol. https://doi.org/10.1097/RHU.0000000000000877
Gisbert JP, Villagrasa JR, Rodríguez-Nogueiras A, Chaparro M (2012) Efficacy of hepatitis B vaccination and revaccination and factors impacting on response in patients with inflammatory bowel disease. Am J Gastroenterol 107:1460–1466
doi: 10.1038/ajg.2012.79
Jiang H-Y, Wang S-Y, Deng M, Li Y-C, Ling Z-X, Shao L, Ruan B (2017) Immune response to hepatitis B vaccination among people with inflammatory bowel diseases: a systematic review and meta-analysis. Vaccine 35:2633–2641
doi: 10.1016/j.vaccine.2017.03.080
Lunel-Fabiani F, Masson C, Ducancelle A (2014) Systemic diseases and biotherapies: understanding, evaluating, and preventing the risk of hepatitis B reactivation. Joint Bone Spine 81:478–484
doi: 10.1016/j.jbspin.2014.01.015
Szczygielska I, Hernik E, Kwiatkowska M, Rutkowska-Sak L, Kołodziejczyk B, Gazda A (2015) Assessment of the level of vaccine-induced anti-HBs antibodies in children with inflammatory systemic connective tissue diseases treated with immunosuppression. Reumatologia 53:56–60
doi: 10.5114/reum.2015.51503
Hepatitis B Foundation (2019) Vaccine non-responders. http://www.hepb.org/prevention-and-diagnosis/vaccination/vaccine-non-responders/ . Accessed 23 October 2019