TNF alpha inhibitors and influenza vaccination

There’s an interesting study on the immune response to the pandemic influenza A H1N1 vaccine in patients receiving TNF alpha inhibitors for rheumatoid arthritis and spondyloarthritis.

I.L. França and colleagues at the immune response of inflammatory arthritis patients on TNF blockers and could show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine for the different TNF alpha inhibitors or maybe better for different classes of. The full text is here: http://eutils.ncbi.nih.gov/pubmed?term=PMID%3A%2022908326.

The results of the study show a seroconversion rate of 58.2% for patients on TNF blockers vs 74.3% for healthy controls. The authors looked at the difference of monoclonal antibody [MAB] TNF blockers like infliximab or adalimumab and Etanercept. A seroconversion rate of 51.6% has been observed for patients on MAB TNF blockers vs 74.3% for healthy controls, which is highly significant (P = 0.005). But for for patients on etanercept there isn’t any difference “(86.7% vs 74.3%, P = 0.091)”. Patients receiving TNF blockers for spondyloarthritis had a lower rate of seroconversion and interestingly patients with rheumatoid arthritis showed no difference to healthy controls. And in further statistical analysis two factors were found to be significant for the lower seroconversion rate in spondyloarthritis patients: older age and receiving MAB TNF blockers.

To sum it up: the seroconversion rate of older spondyloarthritis patients on MAB TNF blockers is reduced, so that they might have to be vaccinated a second time.