The Use of 23-Valent Pneumococcal Polysaccharide Vaccine in Patients with Rheumatoid Arthritis

• Main Authors: M. S. Naumtseva, B. S. Belov, G. M. Tarasova, D. E. Karateev, E. L. Luchikhina, Yu. V. Muravyev, E. N. Aleksandrova, A. A. Novikov
• Format: Article
• Language: Russian
• Published: Numikom LLC 2015-08-01
• Series: Эпидемиология и вакцинопрофилактика
• Subjects: rheumatoid arthritis; autoimmune diseases; comorbid infections; comorbidity; pneumonia; bronchitis; pneumococcal vaccine; vaccination; immunogenicity; efficacy; tolerability
• Online Access: https://www.epidemvac.ru/jour/article/view/384
• ISSN: 2073-3046; 2619-0494

Objective: to study the clinical efficacy, immunogenicity, and safety of a 23-valent pneumococcal vaccine in patients with rheumatoid arthritis (RA).Subjects and methods. The investigation enrolled 102 patients (78 women and 24 men, aged 23 – 70 years), including 72 patients with RA and 30 people without systemic inflammatory rheumatic diseases (a control group) who had a recent history of 2 and more cases of lower respiratory tract infections (bronchitis, pneumonia). When included, all the patients received anti-inflammatory therapy with methotrexate (MT) (n = 52), leflunomide (LEF) (n = 10), or MT + tumor necrosis factor-α (TNF-α ) inhibitors (n = 10). A single 0.5-ml dose of the 23-valent pneumococcal vaccine was administered subcutaneously during continuous MT or LEF therapy for the underlying disease or 3 – 4 weeks before the use of a TNF-α inhibitor. During control visits (1 and 3 months and 1 year after administration of the vaccine), the patients underwent physical examination and routine clinical and laboratory studies.Results. No clinical and radiological symptoms of pneumonia were recorded in any case during a 12-month follow-up. The RA and control groups showed a more than 2-fold increase in anti-pneumococcal antibody levels 1 year after vaccination. The vaccine was well tolerated by 67 patients. 27 patients were observed to have pain, cutaneous swelling and hyperemia and 8 patients had subfebrility. There were neither episodes of RA exacerbation nor new autoimmune disorders during the follow-up.Conclusion. The findings suggest that 23-valent pneumococcal vaccine shows a good clinical efficacy, adequate immunogenicity, and good tolerability in the patients with RA.