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Vaccination survey in patients with rheumatoid arthritis: a cross-sectional study

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Abstract

The objective of this study is to evaluate the vaccination status in rheumatoid arthritis (RA) patients during routine clinical practice, data from a German non-interventional cross-sectional study. In this prospective study, patients with rheumatoid arthritis were interviewed using a standardized questionnaire focusing on vaccination. Available vaccination documents were evaluated, and titers for common vaccination antigens (hepatitis B, rubella, mumps, measles, diphtheria, tetanus) were analyzed with special regard to the underlying treatment and age of patients. A total of 301 RA patients treated with conventional DMARDs alone (cohort I, n = 125), TNF-blocking agents (cohort II, n = 117), or B-cell depletion with rituximab (cohort III, n = 59) have been studied. Significantly more patients in the biologic cohorts II and III were aware of an increased risk of infections (I: 67.7%, II: 83.8%*, III: 89.9%*, P < 0.05). Pneumococcal vaccination rate was significantly higher (I: 20.2%, II 36.8%* and III: 39.0%*, P < 0.05) compared with cohort I. Differences were less evident for influenza. Significantly more patients ≥60 years of age have been vaccinated against Streptococcus pneumoniae and influenza. An obvious discrepancy existed between vaccination awareness and actual vaccination rates for all cohorts. No significant differences in vaccination titers could be seen between the three cohorts. Awareness of infectious complications was more present in patients treated with biologicals, and also, the rate of patients vaccinated against Streptococcus pneumoniae increased significantly depending on the underlying treatment. Nevertheless, there was a discrepancy between vaccination awareness and actual vaccination rates for all cohorts.

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Abbreviations

DMARD:

Disease-modifying antirheumatic drug

RF:

Rheumatoid factor

ACPA:

Anti-citrullinated-peptide Antibodies

DAS28:

Disease activity score 28

WHO:

World health organization

STIKO:

German standing vaccination committee (Ständige Impfkommission)

MTX:

Methotrexate

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Acknowledgments

Funding for this study was provided by an unrestricted grant of Roche Pharma AG. The authors wish to thank all of the physicians and patients who participated in this non-interventional study.

Conflict of interest

The authors have nothing to disclose.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik II, Universität Wuerzburg, Schwerpunkt Rheumatologie/Klinische Immunologie, Oberdürrbacherstrasse 6, 97080, Wuerzburg, Germany

    Martin Feuchtenberger, Stefan Kleinert, Sven Schwab, Petra Roll, Eva Christina Scharbatke, Eva Ostermeier, Arne Schäfer & Hans-Peter Tony

  2. Medizinische Klinik III, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen-Nürnberg, Germany

    Reinhard E. Voll

Authors
  1. Martin Feuchtenberger
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  2. Stefan Kleinert
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  3. Sven Schwab
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  4. Petra Roll
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  5. Eva Christina Scharbatke
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  6. Eva Ostermeier
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  7. Reinhard E. Voll
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  8. Arne Schäfer
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  9. Hans-Peter Tony
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Correspondence to Martin Feuchtenberger.

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Feuchtenberger, M., Kleinert, S., Schwab, S. et al. Vaccination survey in patients with rheumatoid arthritis: a cross-sectional study. Rheumatol Int 32, 1533–1539 (2012). https://doi.org/10.1007/s00296-011-1808-z

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  • DOI: https://doi.org/10.1007/s00296-011-1808-z

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