Table 2

Immune response following vaccination with single dose, two doses or irrespective of number of doses
All patients (number = 291) RA on MTX (number = 50) RA on anti-TNF monotherapy (number = 38) RA on anti-TNF + MTX (number = 53) RA on abatacept (number = 5) RA on rituximab (number = 10) RA on tocilizumab (number = 2) SpA on anti-TNF monotherapy (number = 41) SpA on anti-TNF + MTX (number = 51) SpA on NSAIDs/ analgesics controls (number = 41)
Patients immunized with a single dose of the vaccine (number = 123)
Number of patients 123 18 18 15 3 4 0 13 18 34
GMT prevaccination mean (95% CI) 9.3 (7.2 to 12.1) 6.8 (5.1 to 9.1) 10.8 (6.4 to 18.3) 6.9 (5 to 9.5) 16 (1.1 to 220) 7.1 (2.3 to 21.3) --- 8.5 (5.4 to 13.5) 10 (6.9 to 14.5) 8.8 (6.7 to 11.7)
GMT postvaccination mean (95% CI) 52.4 (34.3 to 80.1) 34.3 (16.6 to 70.8) 30.5 (14.6 to 64) 19.1 (11.2 to 32.5) 49 (2 to 790) 14.1 (3.4 to 59) --- 40 (21.6 to 74) 23.3 (12.7 to 43) 46.1 (29 to 73.9)
Geometric mean fold increase (95% CI) 5.6 (3.6 to 8.8) 5 (2.1 to 12.2) 2.8 (1.6 to 5.1) 2.8 (1.4 to 5.4) 2.5 (0.3 to 18.4) 2 (0.4 to 9.5) --- 4.7 (2.1 to 10.5) 2.3 (1.1 to 4.8) 5.2 (3.2 to 8.4)
Number (% ) of patients with prevaccination titer ≥40 8 (7%) 0 2 (11%) 0 1 (33%) 0 --- 1 (8%) 1 (6%) 3 (9%)
Number (% ) of patients with postvaccination titer ≥40 (seroprotection) 61 (49.1%) 9 (50%) 8 (44%) 6 (40%) 1 (33%) 1 (25%) --- 7 (54%) 8 (44%) 21 (62%)
Number (%) of patients with positive immune response (seroconversion)a 55 (45%) 8 (44%) 6 (33%) 6 (40%) 1 (33%) 1 (25%) ---- 7 (54%) 7 (39%) 19 (56%)
% immunized with seasonal influenza vaccine (2009/2010) 22 33 44 20 0 0 ---- 0 11 24
aNo significant differences between treatment groups.
Patients immunized with two doses of the vaccine (number = 168)
Number of patients 168 32 20 38 2 6 2 28 33 7
GMT prevaccination mean (95% CI) 9.2 (8.2 to 10.4) 9.8 (7.1 to 13.4) 8.7 (6.3 to 12.1) 6.8 (5.6 to 8.3) 20 (3.3 to 121) 7.9 (3.7 to 16.8) 28 (0.3 to 2312) 9.5 (7.1 to 12.7) 10.7 (8.1 to 14.1) 12.2 (5 to 29.5)
GMT postvaccination mean (95% CI) 50 (40.4 to 61.8) 40 (23.9 to 67.5) 72 (33 to 159) 34 (21.5 to 54) 33.6 (6.4 to 176) 8.9 (3.8 to 21) 113 102.5 (69 to 153) 48.3 (32 to 73.4) 97.5 (33 to 291)
Geometric mean fold increase (95% CI) 5.4 (4.3 to 6.8) 4.1 (2.5 to 6.7) 8.3 (3.7 to 18.5) 5 (3–8.3) 2 1.1 (0.5 to 2.6) 4 (0---) 11 (6.7 to 17.3) 4.5 (2.6 to 7.8) 8 (1.5 tp\o 43.6)
N (% ) of patients with prevaccination titer ≥40 17 (10%) 6 (19%) 1 (5%) 1 (3%) 1 (50%) 0 1 (50%) 2 (7%) 3 (9%) 2 (29%)
N (% ) of patients with postvaccination titer ≥40 106 (63%) 16 (50%) 14 (70%) 18 (48%) 1 (50%) 1 (17%) 2 (100%) 24 (86%) 24 (73%) 6 (86%)
N (%) of patients with positive immune response (seroconversion) 91 (54%) 13 (41%)b 14 (70%) 17 (45%) 0 0 1 (50%) 24 (86%)a 17 (52%) 5 (71%)
% immunized with seasonal influenza vaccine (2009/2010) 46% 59% 40% 51% 100 50 100 32 36 43
aP = 0.003 compared to RA on MTX; P = 0.033 compared to RA on anti-TNF monotherapy; P = 0.001 compared to RA on anti-TNF + MTX; P = 0.005 compared to SpA on antiTNF + MTX; bP = 0.039 versus RA on anti-TNF monotherapy (Chi2 test).
All vaccinated patients regardless of number of doses (number = 291)
Number of patients 291 50 38 53 5 10 2 41 51 41
GMT prevaccination mean (95% CI) 9 (8.2 to 9.8) 8.6 (6.8 to 10.8) 9.6 (7.2 to 12.9) 6.8 (5.8 to 8) 17.4 (3.7 to 81.2) 7.6 (4.7 to 12.2) 28.3 ----- 9.2 (7.3 to 11.6) 10.4 (8.4 to 12.9) 9.3 (7.2 to 12.1)
GMT postvaccination mean (95% CI) 41.4 (35.3 to 48.4) 37.8 (25.1 to 57) 48 (28.1 to 82.1) 28.8 (20.2 to 41.3) 40 (11.8 to 135) 10.7 (5.9 to 19.4) 113.1 ----- 76 (53.5 to 105) 37.4 (26.4 to 53) 52.4 (34.3 to 80.1)
Geometric mean fold increase (95% CI) 4.6 (3.9 to 5-5) 4.4 (2.9 to 6.9) 5 (3 to 8.3) 4.2 (2.8 to 6.3) 2.3 (0.9 to 5.9) 1.4 (0.8 to 2.6) 4 8.3 (5.5 to 12.5) 3.6 (2.3 to 5.5) 5.6 (3.6 to 8.8)
N (% ) of patients with prevaccination titer ≥40 25 (9%) 6 (12%) 3 (8%) 1 (2%) 2 (40%) 0 1 (50%) 3 (7%) 4 (8%) 5 (12%)
N (% ) of patients with postvaccination titer ≥40 (seroprotection) 167 (57%) 25 (50%) 22 (58%) 24 (45%) 2 (40%) 2 (20%) 2 (100%) 31 (76%) 33 (63%) 27 (66%)
N (%) of patients with positive immune response (seroconversion) 146 (50%) 21 (42%)b 20 (53%)c 23 (43%)d 1 (20%) 1 (10%) 1 (50%) 31 (76%)a 24 (47%) 24 (59%)
% immunized with seasonal influenza vaccine (2009/2010) 104 (36%) 50% 42% 42% 40% 30% 100% 22% 28% 27%
aP = 0.001 compared to RA on MTX; P = 0.033 compared to RA on anti-TNF as monotherapy; P = 0.002 compared to RA on anti-TNF + MTX; P = 0.011 compared to RA on abatacept; P < 0.001 compared to RA on rituximab; P = 0.006 compared to SpA on anti-TNF + MTX; bP = 0.05 compared to RA on rituximab; cP = 0.013 compared to RA on rituximab; P = 0.033 compared to SpA on dP = 0.046 compared to RA on rituximab (Chi2 test/Fisher’s exact test).

Positive immune response, that is seroconversion, was defined as prevaccination titers <10 and postvaccination HI titers ≥40 or a ≥4-fold increase in HI titers. Percentages of patients vaccinated against seasonal influenza during the 2009/2010 winter season are also given. CI, confidence interval; GMT, geometricial mean antibody titer; HI, hemagglutination inhibition; MTX, methotrexate; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis; SpA, spondylarthropathy.

Kapetanovic et al.

Kapetanovic et al. Arthritis Research & Therapy 2014 16:R2   doi:10.1186/ar4427

Open Data