Pneumococcal polysaccharide vaccination in rheumatoid arthritis patients receiving tocilizumab therapy.

Abstract:

OBJECTIVES:We assessed the impact of tocilizumab (TCZ), a humanised monoclonal anti-interleukin-6 receptor antibody, on antibody response following administration of the 23-valent pneumococcal polysaccharide vaccine (PPV23). METHODS:A total of 190 patients with rheumatoid arthritis (RA) received PPV23. Patients were classified into TCZ (n=50), TCZ + methotrexate (MTX) (n=54), MTX (n=62) and RA control (n=24) groups. We measured serotype-specific IgG concentrations of pneumococcal serotypes 6B and 23F using ELISA and functional antibody activity using a multiplexed opsonophagocytic killing assay, reported as the opsonisation indices (OIs), before and 4-6 weeks after vaccination. Positive antibody response was defined as a 2-fold or more increase in the IgG concentration or as a ≥10-fold or more increase in the OI. RESULTS:IgG concentrations and OIs were significantly increased in all treatment groups in response to vaccination. The TCZ group antibody response rates were comparable with those of the RA control group for each serotype. MTX had a negative impact on vaccine efficacy. Multivariate logistic analysis confirmed that TCZ is not associated with an inadequate antibody response to either serotype. No severe adverse effect was observed in any treatment group. CONCLUSIONS:TCZ does not impair PPV23 immunogenicity in RA patients, whereas antibody responses may be reduced when TCZ is used as a combination therapy with MTX.

journal_name

Ann Rheum Dis

authors

Mori S,Ueki Y,Akeda Y,Hirakata N,Oribe M,Shiohira Y,Hidaka T,Oishi K

doi

10.1136/annrheumdis-2012-202658

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

1362-6

issue

8

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2012-202658

journal_volume

72

pub_type

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