Navigation Links
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 they received MTX alone or rituximab in combination with MTX.

Patients treated only with MTX had a greater response to the pneumonia vaccine compared with those also receiving rituximab. Researchers found that only 57% of patients treated with rituximab had a response to one type of pneumococcal vaccine (Pneumovax) compared with 82% of MTX-only patients.

The ability to maintain a positive delayed-type hypersensitivity (DTH) response to the Candida albicans skin test was comparable in both groups with 77.4% of rituximab-treated patients and 70% of MTX-only patients responding. "Our study, the first to examine DTH responses, confirmed that rituximab had no incremental effect on the patient's ability to mount a DTH response," said Dr. Bingham.

Treatment with rituximab produces a rapid depletion of B cells from the circulation, impacting the body's immune function. This depleted B cell pool begins to recover approximately 6-9 months after the initial treatment with rituximab. In his editorial also published in Arthritis & Rheumatism, E. William St. Clair, M.D. from Duke University Medical Center highlighted the need for further research into the effects of rituximab treatment.

"Further studies similar to Bingham et al are necessary to understand the complex effects of rituximab therapy on immune responses," noted Dr. St. Clair. "This study only evaluated immunization responses approximately 6 months after rituximab was administered; the responses at earlier time points, based on animal studies and its mechanism of action, may have been further attenuated," St. Clair added.


'/>"/>

Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Penn study finds pro-death proteins required to regulate healthy immune function
2. Immune deficiency linked to a type of eye cancer
3. Tumors use enzyme to recruit regulatory T-cells and suppress immune response
4. Melanoma drug revs immune cells but cancer cells ignore it
5. Study identifies key player in the bodys immune response to chronic stress
6. MedImmune Resolves FDA Observations Regarding Manufacturing Process for FluMist(R)
7. UVA researchers find important clue to immune infertility
8. M.D. Anderson-led team reports possible key to autoimmune disease
9. Their immune cells, fighting your cancer
10. MedImmune Licenses Reverse Genetics Technology to GlaxoSmithKline for Use in Influenza Vaccine Development and Production
11. Occupational exposures may be linked to death from autoimmune disease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... ... 05, 2016 , ... Health and wellness is a topic that should concern ... they are experiencing an illness. Migraines are a severe form of a headache and ... would not wish the pain on their worst enemy, the feeling can last for ...
(Date:2/5/2016)... Ramsey, NJ (PRWEB) , ... February 05, 2016 ... ... Optimizing Primary Care for Patients with Rare Diseases, a continuing medical education (CME) ... conference is the first of its kind—and a first for ACCORD, whose mission ...
(Date:2/5/2016)... ... 05, 2016 , ... KICVentures ( http://www.kicventures.com ) announced today ... New York City on Thursday, January 21, 2016. Kingsley R. Chin, the ... of the varsity Columbia soccer program) spoke at the event, offering professional insight ...
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... Susan ... Medicare San Luis Obispo users can expect to see in 2016. To view the ... most significant changes will directly impact many San Luis Obispo seniors who rely on ...
(Date:2/4/2016)... Verdes, CA (PRWEB) , ... February 04, 2016 ... ... at the "It's All About YOU Re-Treat" on February 19-21, 2016, in ... Re-Treat" is at Rancho Palos Verdes, California. These 30 professional speakers, including Clinical ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... Feb. 5, 2016 ... the "Global Obstetrics Partnering 2010-2016: Deal ... to their offering. --> http://www.researchandmarkets.com/research/hcdvg6/global_obstetrics ... "Global Obstetrics Partnering 2010-2016: Deal trends, ... their offering. --> Research and ...
(Date:2/4/2016)... LONDON , Feb. 4, 2016 ... to achieve significant growth as next generation systems ... and use radiology for cancer surgery. New systems ... radiological overdosing that has been such a problem ... be delivered. Radiosurgery robots take cancer surgery far ...
(Date:2/4/2016)... 2016  Montoya Love is recognized by Continental Who,s ... Pharmaceuticals. Montoya is the Regulatory Systems Operations Manager with ... Manufacturing and selling a broad range ... provides healthcare institutions, clinical laboratories and life science researchers ... the globe. ...
Breaking Medicine Technology: