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Immune responses to tetanus vaccine unchanged for RA patients on rituximab
Date:1/6/2010

Researchers from Johns Hopkins University determined that immune responses to the tetanus vaccine were not changed when rituximab in combination with methotrexate (MTX) was compared with MTX alone in patients with rheumatoid arthritis (RA). Responses to a pneumococcal vaccination (Pneumovax pneumonia vaccine), however, were reduced in RA patients with rituximab. Complete findings of this study are published in the January 2010 issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.

According to the Centers for Disease Control and Prevention (CDC), RA affects 1.3 million adults in the U.S. (2005). RA patients may be at an increased risk of infection because of impaired immune function due to the disease as well as from the use of immunsuppressive medications. As a result, vaccinations against infections are an essential part of rheumatic disease management. How immunosuppressive agents alter the effectiveness of vaccines in RA patients was the focus of the clinical trial led by Clifton O. Bingham III, M.D.

The controlled study enrolled 103 RA patients from 26 centers in the U.S. between January 2006 and December 2007. Patients treated with a stable dose (10-25 mg/week) of MTX were randomly allocated to two groups: placebo and treatment with rituximab (2 x 1000 mg given two weeks apart). Both groups were immunized with the tetanus and pneumococcal vaccines along with keyhole limpet hemocyanin (KLH) to evaluate humoral immunity and skin tested with Candida albicans to evaluate the cellular immune response.

Results indicate that 39.1% of patients in the rituximab+MTX group and 42.3% of MTX-only patients demonstrated a 4-fold rise in the anti-tetanus IgG titer. A 2-fold rise was confirmed in 54.7% of rituximab-treated patients and 61.5% of subjects on MTX alone. The research demonstrates that RA patients given a tetanus vaccine responded the same to tetanus vaccination regardless of whether th
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Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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