Introduction:
Juvenile idiopathic arthritis (JIA) is the most common rheumatological
disease of childhood. The
therapy with
tumor necrosis factor (TNF) inhibitors (TNFi) in JIA
patients has demonstrated
efficacy and
safety. The most reported
adverse event is the high susceptibility to
infections. Preventive
vaccination helps to decrease these
risks. The information on response to
vaccines in JIA
patients having
treatment with anti-TNF is limited.
Objectives:
To evaluate the response to
pneumococcal vaccine in JIA
patients undergoing
treatment with mAb. Materials and
methods Analytical observational mixed
cohort study. Data obtained from the clinical
records of an immunorheumatology
polyclinic of a
metropolitan hospital in Santiago (
Chile).
Treatments,
pneumococcal vaccine schedules, immunological
laboratory, and measurement of specific
antibodies against 10 pneumococcal
serotypes were recorded.
Results:
Nineteen
patients were included; average age was 13.8 years; and average evolution
time of the
disease was 46.2 months.
Adalimumab (
Humira®) was indicated in case of 13
patients (68.4%) and
etanercept (
Enbrel®) to 6 (31.5%). The most indicated scheme was a
dose of 13-valent pneumococcal
conjugate vaccine (PCV13) followed at 8 weeks by a
dose of
pneumococcal polysaccharide vaccine (PPSV23) in nine (47.3%)
patients. Seventeen (89.4%)
patients were on immunosuppressive
treatment at the
time of
vaccination. Only one
patient did not meet the criteria for response to
vaccine.
Conclusions:
The
pneumococcal vaccine induces protective levels of
serum antibodies in JIA
patients undergoing TNFi
treatment. The
vaccination schedule and the
lymphocyte count could influence the response capacity (AU)