Immunogenicity of Influenza Vaccine for @entity1 with XXXX on Maintenance Infliximab Therapy: A Randomized Trial.

@entity1 @entity683 @entity29
BACKGROUND: In @entity1 with @entity29 ( @entity29 ) on infliximab, data are limited on immune response to @entity683 vaccine and the impact of vaccine timing. The study aims were to evaluate immune responses to the @entity683 vaccine in @entity29 @entity1 on infliximab and the impact of vaccine timing on immune responses. METHODS: In this randomized study, 137 subjects with @entity29 on maintenance infliximab therapy were allocated to receive the 2012/2013 inactivated @entity683 vaccine at the time of infliximab infusion (n = 69) or midway between infusions (n = 68). Serum was collected before and after vaccination for hemagglutination inhibition titers. Serologic protection was defined by postvaccine titer of >= 1:40. RESULTS: Comparing subjects vaccinated at the time of infliximab with those vaccinated midway, serologic protection was achieved in 67% versus 66% to H1N1 (P = 0.8), in 43% versus 49% to H3N2 (P = 0.5), and in 69% versus 79% to @entity683 B (P = 0.2). Although solicited adverse events were common (60%), no subject experienced a serious adverse event requiring additional medical attention. Only 6% of subjects had a clinically significant increase in disease activity score, not impacted by vaccine timing. CONCLUSIONS: Serologic protection to @entity683 vaccine is achieved in only approximately 45% to 80% of @entity29 @entity1 on maintenance infliximab therapy varying by antigen. Yet, importantly, vaccine timing relative to infliximab infusion does not affect the achievement of serologic protection, and the @entity683 vaccine is well tolerated. Therefore, @entity683 vaccination at any point during infliximab scheduling is recommended for @entity1 with @entity29 and opportunities to broaden the availability and convenience of @entity683 vaccine to optimize coverage should be explored.
