Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study

被引：37

作者：

Jaeger, Veronika K. ^{[1
]}

Hoffman, Hal M. ^{[2
,3
]}

van der Poll, Tom ^{[4
,5
]}

Tilson, Hugh ^{[6
]}

Seibert, Julia ^{[7
]}

Speziale, Antonio ^{[7
]}

Junge, Guido ^{[7
]}

Franke, Kristina ^{[8
]}

Vritzali, Eleni ^{[7
]}

Hawkins, Philip N. ^{[9
]}

Kuemmerle-Deschner, Jasmin ^{[10
]}

Walker, Ulrich A. ^{[1
]}

机构：

[1] Univ Hosp Basel, Dept Rheumatol, Petersgraben 4, CH-4031 Basel, Switzerland

[2] Univ Calif San Diego, Dept Med, La Jolla, CA 92093 USA

[3] Rady Childrens Hosp, Div Allergy & Immunol, San Diego, CA USA

[4] Univ Amsterdam, Div Infect Dis, Amsterdam, Netherlands

[5] Univ Amsterdam, Ctr Expt & Mol Med, Acad Med Ctr, Amsterdam, Netherlands

[6] Univ N Carolina, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA

[7] Novartis Pharma AG, Basel, Switzerland

[8] QuintilesIMS, Real World Insights, Res Triangle Pk, NC USA

[9] UCL, Natl Amyloidosis Ctr, London, England

[10] Univ Hosp Tuebingen, Dept Pediat, Div Pediat Rheumatol, Tubingen, Germany

来源：

RHEUMATOLOGY | 2017年 / 56卷 / 09期

关键词：

cryopyrin-associated periodic syndromes; CAPS; vaccinations; safety; PNEUMOCOCCAL PNEUMONIA; INFLAMMASOME; PATHOGENESIS; VACCINE;

D O I：

10.1093/rheumatology/kex185

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives. Pneumococcal, tetanus and influenza vaccinations are recommended for patients with cryopyrin- associated periodic syndromes (CAPS) when treated with immunosuppressive medication. The aim of this publication is to report the safety of pneumococcal and other vaccinations in CAPS patients. Methods. All CAPS patients followed in the beta-CONFIDENT (Clinical Outcomes and Safety Registry study of Ilaris patients) registry were analysed if they had received a vaccination. The b-CONFIDENT registry is a global, long-term, prospective, observational registry, capturing and monitoring patients treated with canakinumab. Results. Sixty-eight CAPS patients had received a total of 159 vaccine injections, 107 injections against influenza, 19 pneumococcal vaccinations, 12 against tetanus/diphtheria antigens and 21 other vaccinations. Fourteen per cent of injections had elicited at least one vaccine reaction. All five vaccine-related serious adverse events were associated with pneumococcal vaccination. Vaccine reactions were observed in 70% of pneumococcal vaccinations, compared with 7% in influenza and 17% in tetanus/diphtheria vaccinations. The odds ratios to react to the pneumococcal vaccines compared with influenza and tetanus/diphtheria vaccines were 31.0 (95% CI: 8, 119) and 10.8 (95% CI: 2, 74). Vaccine reactions after pneumococcal vaccinations were more severe and lasted significantly longer (up to 3 weeks) compared with other vaccinations. In two patients, pneumococcal vaccination also elicited symptoms consistent with systemic inflammation due to CAPS reactivation. Conclusion. Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic inflammation in CAPS patients. Clinicians must balance potential benefits of pneumococcal immunization against safety concerns. The 13-valent pneumococcal conjugate vaccine might be favourable over the polysaccharide vaccine in CAPS patients.

引用

页码：1484 / 1491

页数：8

共 18 条

[1] In vivo and in vitro IL-18 production during uveitis associated with Behcet disease: Effect of glucocorticoid therapy
Belguendouz, H.
Messaoudene, D.
Lahmar-Belguendouz, K.
Djeraba, Z.
Otmani, F.
Terahi, M.
Tiar, M.
Hartani, D.
Lahlou-Boukoffa, O. S.
Touil-Boukoffa, C.
[J]. JOURNAL FRANCAIS D OPHTALMOLOGIE, 2015, 38 (03): : 206 - 212
[2] Mutations in the autoinflammatory cryopyrin-associated periodic syndrome gene: epidemiological study and lessons from eight years of genetic analysis in France
Cuisset, L.
Jeru, I.
Dumont, B.
Fabre, A.
Cochet, E.
Le Bozec, J.
Delpech, M.
Amselem, S.
Touitou, I.
[J]. ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (03) : 495 - 499
[3] Canakinumab: In patients with cryopyrin-associated periodic syndromes
Monique P. Curran
[J]. BioDrugs, 2012, 26 (1) : 53 - 59
[4] Crucial role for the Nalp3 inflammasome in the immunostimulatory properties of aluminium adjuvants
Eisenbarth, Stephanie C.
Colegio, Oscar R.
O'Connor, William, Jr.
Sutterwala, Fayyaz S.
Flavell, Richard A.
[J]. NATURE, 2008, 453 (7198) : 1122 - U13
[5] Immunogenicity and safety of pneumococcal vaccination in patients with rheumatoid arthritis or systemic lupus erythematosus
Elkayam, O
Paran, D
Caspi, D
Litinsky, I
Yaron, M
Charboneau, D
Rubins, JB
[J]. CLINICAL INFECTIOUS DISEASES, 2002, 34 (02) : 147 - 153
[6] Kuemmerle-Deschner JB, 2015, ARTHRITIS RHEUMA S10, V67
[7] Pneumolysin Activates the NLRP3 Inflammasome and Promotes Proinflammatory Cytokines Independently of TLR4
McNeela, Edel A.
Burke, Aine
Neill, Daniel R.
Baxter, Cathy
Fernandes, Vitor E.
Ferreira, Daniela
Smeaton, Sarah
El-Rachkidy, Rana
McLoughlin, Rachel M.
Mori, Andres
Moran, Barry
Fitzgerald, Katherine A.
Tschopp, Jurg
Petrilli, Virginie
Andrew, Peter W.
Kadioglu, Aras
Lavelle, Ed C.
[J]. PLOS PATHOGENS, 2010, 6 (11)
[8] Safety and Antibody Response, Including Antibody Persistence for 5 Years, after Primary Vaccination or Revaccination with Pneumococcal Polysaccharide Vaccine in Middle-Aged and Older Adults
Musher, Daniel M.
Manoff, Susan B.
Liss, Charlie
McFetridge, Richard D.
Marchese, Rocio D.
Bushnell, Bonnie
Alvarez, Frances
Painter, Carla
Blum, Michael D.
Silber, Jeffrey L.
[J]. JOURNAL OF INFECTIOUS DISEASES, 2010, 201 (04) : 516 - 524
[9] Cryopyrinopathies: update on pathogenesis and treatment
Neven, Benedicte
Prieur, Anne-Marie
Maire, Pierre Quartier Dit
[J]. NATURE CLINICAL PRACTICE RHEUMATOLOGY, 2008, 4 (09): : 481 - 489
[10] Nuorti J. P., 2010, Morbidity and Mortality Weekly Report, V59, P1102

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