No differential effect of the DMARDs around the humoral response could be demonstrated

No differential effect of the DMARDs around the humoral response could be demonstrated. patients than healthy controls (significant for HK). The percentage of responders was not affected by prednisone or any DMARD, including methotrexate, infliximab, and etanercept. Indices of disease activity remained unchanged. Conclusions Influenza computer virus vaccine generated a good humoral response in rheumatoid patients, although lower than in healthy controls. The AZD1208 HCl response was not affected by the use of prednisone or DMARDs. tests. EPHB2 Switch in drug use was evaluated by the McNemar test, in quantity of drugs by the Wilcoxon test, and in drug dosage by paired tests. Statistical analysis was carried out using the SAS system for Windows, release 8.02. Results Characteristics of patients and control subjects The two groups were statistically comparable in terms of age and sex. All groups were predominantly female (table 1?1),), with a mean age of 59 years for rheumatoid arthritis and 53 years for controls. At the time of vaccination, all rheumatoid patients were being treated with at least one DMARD. Fifty six of 82 AZD1208 HCl patients were being treated with methotrexate at a mean dose of 12?mg/week, 48 were on prednisone at a mean dose of 8?mg/d, 22 were receiving infliximab, and five were on etanercept. These drugs had been given for at least three months by the time of vaccination (table 2?2). Table 1?Clinical and demographic characteristics of rheumatoid arthritis patients and control subjects 87%; p?=?0.05). The proportion of responders was comparable for PAN (53% 54%) and NC (53% 68%) (table 5?5).). Response to more than one antigen was obtained in 70% of rheumatoid patients 82% of controls. Table 5?Number (%) of responders: rheumatoid arthritis patients and Controls has previously been shown by our group to induce an adequate humoral response in a group of rheumatoid patients, although this was lower than in controls.16 Immunosuppressive drugs did not seem to affect the humoral response, with the exception of infliximab which was shown to reduce it.17 Mease could not show a deleterious effect of etanercept around the humoral response to pneumococcal vaccine in a group of patients with psoriatic arthritis, while methotrexate caused a reduced response.18 Similar results around the detrimental effect of methotrexate were suggested by O’Dell in a group of rheumatoid patients.19 Concerning influenza, Chalmers could not demonstrate any correlation between the use and dose of prednisone or gold around the immunogenicity of the influenza vaccine in a cohort of rheumatoid patients.9 In children and adults with asthma, the immune response to inactivated influenza vaccine was not found to be adversely affected by corticosteroid therapy,20 while ciclosporine has been related to a reduced immune response to influenza vaccination in lung transplant patients.21 Our present study has shown that neither the use of methotrexate nor of infliximab affected the humoral response. In conclusion, this study has shown that in a real life cohort of rheumatoid patients, immunisation against influenza did not modify the clinical picture of rheumatoid arthritis. In addition, our results indicate that long term immunosuppressive therapy AZD1208 HCl at standard doses, including TNF blockers, did not adversely impact the humoral response to the vaccine. No differential effect of the DMARDs around the humoral response could be demonstrated. We are aware of the limitations of this study, which included a relatively small number of patients and controls, and this may have influenced the results. However, based on our present data, we feel that vaccination against influenza, which is usually strongly indicated in rheumatoid arthritis, can be recommended in patients with this disease. Abbreviations DMARD – disease modifying antirheumatic drug GMT – geometric imply titre HA – haemagglutinin HAQ – Health Assessment Questionnaire HIT – haemagglutination inhibition test NA – neuraminidase RF – rheumatoid factor TNF – tumour necrosis factor .