ANN RHEUM DIS:停用甲氨喋呤对类风湿关节炎接种流感疫苗疗效的影响

2017-05-08 xiangting MedSci原创

对RA患者临时停用MTX可以改善季节性流感疫苗的免疫原性。

这项研究旨在探讨对类风湿关节炎(RA)患者临时停用氨蝶呤(MTX)是否能改善季节性流感疫苗接种的疗效。

在这项前瞻性随机平行试验中,服用稳定剂量MTX的RA患者以1:1的比例随机分组,分为继续MTX组(1组),接种前停止MTX 4周组(2组),接种前后停止MTX 2周组(3组)和接种后停止MTX 4周组(4组)。所有参与者均接种含有H1N1、H3N2和B-Yamagata的三价流感疫苗。主要结果是满意的疫苗反应出现频率(疫苗接种后4周增加4倍)。次要终点包括抗体滴度从基线的倍数变化。

共入组199名患者(1,2,3,4组分别为54,44,49和52名)。第3组对所有三种抗原的疫苗反应均高于第1组(51.0%对31.5%,P= 0.044)。第3组和第4组(分别为12.2(8.4至17.5),P<0.001和10.0(6.8至14.8),P=0.043)的抗H3N2抗体倍数增加(95%CI)均高于组1(5.9(4.3-8.1))。第3组和第4组的抗B-Yamagata抗体反应比组1更高(4.7(3.3至6.7),P= 0.048; 6.1(4.2至8.8),P<0.001)(2.9(2.2至3.8) )。RA发作在1,2,3组和4组分别占24.1%,21.2%,34.1%和38.8%(P= NS)。

由此可见,对RA患者临时停用MTX可以改善季节性流感疫苗的免疫原性。

原始出处:


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    2017-05-10 lmm397
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