Anti-influenza vaccination in systemic lupus erythematosus patients: an analysis of specific humoral response and vaccination safety
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The objective of this study is to evaluate efficacy and safety of influenza vaccine in systemic lupus erythematosus (SLE) patients. We studied SLE patients and healthy subjects immunised with inactivated influenza vaccine. Efficacy was measured by comparing humoral response to vaccine antigens between groups. Safety was monitored by SLEDAI and serological markers. Subjects attended visits at baseline and on post-vaccination weeks 4 and 12. We enrolled 62 SLE patients and 47 healthy subjects. In post-immunisation week 4, anti-haemagglutinin antibody titres rose in the patient group at least 6.23-fold, compared to 11.90-fold among controls (P ≤ 0.05). The seroconversion rate range was 53-56% among patients and 72-85% among controls (P < 0.05 for strains H1N1 and H3N2, NS for strain type B). The seroprotection rate ranged between 62% and 73% and between 90% and 98% in the patient and control group, respectively (P < 0.05). In post-vaccination week 12, the antibody titre was higher at least 3.86-fold in the patient group and 7.65-fold among controls. The seroconversion rate range was 32-40% among patients and 64-70% among controls, while the seroprotection rate ranged between 43% and 50% and between 79% and 94%, respectively (P < 0.005 for three strains). We identified one severe and six mild to moderate SLE exacerbations by week 12. The anti-nuclear antibodies and anti-double-stranded DNA titres grew by post-immunisation week 4 (P < 0.05). The post-vaccination response was weaker in SLE patients compared to healthy subjects. Immunisation did not change underlying disease activity.
KeywordsHumoral response Influenza vaccination Lupus erythematosus Safety
- 2.Update: Novel influenza A (H1N1) virus infections worldwide (2009) MMWR 58:453-458Google Scholar
- 18.Centers for Disease Control and Prevention. WHO Collaborating Center for the Surveillance, Epidemiology and Control of Influenza. Concepts and procedures for laboratory-based influenza surveillance. US Department of Health and Human Services, Public Health Service, July 1982Google Scholar
- 22.Commission of the European Communities (1992) The rules governing medicinal products in the European Community. Commission of the European Communities 3:93–98Google Scholar
- 23.Committee for Proprietary Medicinal Products (CPMP): note for guidance on harmonization of requirements for influenza vaccines. The European Agency for Evaluation of Medicinal Products, Human Medicines Evaluation Unit (EMEA), CPMP/BWP/214/96, 12 March 1997, LondonGoogle Scholar