title: Kinetics of the long-term antibody response after meningococcal C vaccination in patients with juvenile idiopathic arthritis: a retrospective cohort study.
abstract: OBJECTIVE
  The kinetics of the antibody response induced by meningococcal serogroup C (MenC) conjugate vaccination was analysed in patients with juvenile idiopathic arthritis (JIA) to assess their long-term protection against MenC disease.
  
  
  METHODS
  In The Netherlands, a nationwide catch-up campaign was performed in 2002 during which children aged 1-19 years, including JIA patients, received the MenC conjugate vaccination. From 127 JIA patients, IgG antibody concentrations against MenC-polysaccharide were determined by a fluorescent-bead-based immunoassay in 402 serum samples collected between 2002 and 2010. Using a hierarchical linear regression model, the 8 years course of MenC-specific antibodies was analysed in four age groups (13-19, 9-12.9, 5-8.9 and 1-4.9 years), and in patients starting with methotrexate or biologicals. In 65 randomly selected samples, the correlation of MenC-specific IgG concentrations with serum bactericidal assay (SBA) titres was assessed. MenC-specific IgG concentrations at 4.2 years after vaccination were compared with those of 1527 age-matched healthy controls.
  
  
  RESULTS
  MenC-specific IgG concentrations postvaccination were highest in patients aged 13-19 years at time of vaccination. Antibodies gradually waned over time in patients, but their estimated concentrations at 4.2 years postvaccination were similar to those measured in controls. MenC-specific IgG concentrations correlated well with SBA titres (r=0.72, p<0.001). By contrast with methotrexate, starting treatment with biologicals induced a trend towards accelerated decline of MenC-specific antibodies.
  
  
  CONCLUSIONS
  Persistence of MenC-specific IgG antibodies in JIA patients is similar to healthy controls, but treatment with biologicals may induce accelerated antibody waning, resulting in unprotected patients who may need revaccination.
authors.affiliation: Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control Netherlands, National Institute of Public Health and the Environment (RIVM), , Bilthoven, The Netherlands.
authors.forename: Susanne P
authors.initials: SP
authors.lastname: Stoof
authors.forename: Marloes W
authors.initials: MW
authors.lastname: Heijstek
authors.forename: Karen M
authors.initials: KM
authors.lastname: Sijssens
authors.forename: Fiona
authors.initials: F
authors.lastname: van der Klis
authors.forename: Elisabeth A M
authors.initials: EA
authors.lastname: Sanders
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Teunis
authors.forename: Nico M
authors.initials: NM
authors.lastname: Wulffraat
authors.forename: Guy A M
authors.initials: GA
authors.lastname: Berbers
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000097:blood; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000276:immunology*; D001770:Blood Bactericidal Activity / Q000187:drug effects / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000096:biosynthesis / Q000097:blood; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000276:immunology*; D009345:Neisseria meningitidis / Q000276:immunology*; D012189:Retrospective Studies
chemical_list: D000907:Antibodies, Bacterial; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine
keywords: Anti-TNF; Juvenile Idiopathic Arthritis; Methotrexate; Vaccination