Treatment with belimumab in systemic lupus erythematosus does not impair antibody response to 13-valent pneumococcal conjugate vaccine.

• Background/purpose: The objective of this study was to explore the impact of systemic lupuserythematosus and belimumab given in addition to standard of care therapy on 13-valentconjugated pneumococcal vaccine (PCV13) response. Methods: Forty-seven systemic lupuserythematosus patients and 21 healthy controls were immunized with a single dose of13-valent conjugated pneumococcal vaccine. Forty systemic lupus erythematosus patientswere treated with traditional disease-modifying anti rheumatic drugs, 11 of those receivedbelimumab in addition, and 32 patients were treated with concomitant prednisolone.Quantification of serotype specific IgG levels to 12 pneumococcal capsular polysaccharideswas performed in serum taken before and four to six weeks after vaccination using multiplexfluorescent microsphere immunoassay. IgG levels against serotypes 23F and 6B were alsoanalyzed using standard enzyme-linked immunosorbent assays. Opsonophagocyticassay was performed on serotype 23F to evaluate the functionality of the antibodies. Preandpost-vaccination log transformed antibody levels were compared to determine theimpact of systemic lupus erythematosus diagnosis and different treatments on antibodyresponse. Results: Systemic lupus erythematosus patients as a group showed lower postvaccinationantibody levels and lower fold increase of antibody levels after vaccinationcompared to controls (p¼0.02 and p¼0.009, respectively). Systemic lupus erythematosuspatients treated with belimumab in addition to standard of care therapy or with only hydroxychloroquinedid not differ compared to controls, whereas the other treatment groups hadsignificantly lower fold increase of post-vaccination antibody levels. Higher age was associatedwith lower post-vaccination antibody levels among systemic lupus erythematosuspatients. Conclusion: Belimumab given in addition to traditional disease-modifyinganti rheumatic drugs or prednisolone did not further impair antibody response to 13-valentconjugated pneumococcal vaccine.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Nyckelord

belimumab

systemic lupus

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)