J Rheumatol:类风湿关节炎初次加强肺炎球菌接种后的血清学反应

2017-10-23 xiangting MedSci原创

在bDMARD和csDMARD治疗的患者中,PCV13后接种PPV23的初次加强疫苗接种后的早期血清学反应非常相似。

这项研究旨在根据剂量和免疫间隔不同,评估生物性疾病改善抗风湿药物(bDMARD)治疗的类风湿关节炎(RA)患者13价蛋白质共轭肺炎球菌疫苗(PCV13)和23价多糖肺炎球菌疫苗(PPV23)接种后的初步血清学反应。

这是一项研究者发起的临床试验。接受bDMARD治疗的RA患者被随机分组(1:1:1),接种单次剂量PCV13,16或24周后接种PPV23,或双倍剂量PCV13,16周后PPV23。用常规合成(cs)DMARD治疗的RA比较组接受单次剂量PCV13,16周后PPV23。每次疫苗接种前和4周后收集肺炎球菌抗体。主要终点是两次疫苗接种4周后反应≥6/12肺炎球菌血清型的参与者比例。

纳入接受bDMARD的65例参与者和35例接受csDMARD的参与者。在PPV23接种后, bDMARD和csDMARD治疗的参与者分别有87%(95%CI 0.76-0.94)和94%(95%CI 0.77-0.99)达到主要终点。3个随机组间的主要终点无显著差异。利妥昔单抗治疗的参与者反应率为25%,而使用bDMARD治疗的参与者为89%。

在bDMARD和csDMARD治疗的受试者中,PCV13后接种PPV23的初次加强疫苗接种后的早期血清学反应非常相似。然而,不同bDMARD存在显著的反应差异。对RA患者进行肺炎球菌疫苗接种时,应考虑RA的治疗方案对接种效果的影响。

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    2017-10-25 lmm397
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    2017-10-23 惠映实验室

    学习了.谢谢

    0

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