title: Opsonic and Antibody Responses to Pneumococcal Polysaccharide in Rheumatoid Arthritis Patients Receiving Golimumab Plus Methotrexate.
abstract: Vaccination against Streptococcus pneumoniae is recommended for rheumatoid arthritis (RA) patients receiving immunosuppressive treatments. The objective of this study was to evaluate the humoral response to 23-valent pneumococcal polysaccharide vaccination (PPSV23) in RA patients receiving methotrexate (MTX) alone or in combination with a tumor necrosis factor inhibitor, golimumab (GOM).PPSV23 was given to 114 RA patients, who were classified into three groups: RA control (n = 35), MTX alone (n = 55), and GOM + MTX (n = 24). Before and 4 to 6 weeks after vaccination, concentrations of antibodies against pneumococcal serotypes 6B and 23F were measured using an enzyme-linked immunosorbent assay and antibody functionality was determined using a multiplexed opsonophagocytic killing assay, reported as the opsonization index (OI).The IgG concentrations and OIs were both significantly increased in all treatment groups in response to PPSV23 vaccination. In the GOM + MTX group, the IgG responses were lower than those in the MTX alone or control groups, whereas the OI responses were similar to those in the other 2 groups. Furthermore, discrepancies between the IgG and OI responses were found in GOM + MTX group. No severe adverse effect was observed in any treatment groups.OI responses indicate that antibody functionality rather than antibody quantity is important. The similarity of these measurements between all 3 groups suggests that RA patients receiving MTX + GOM still benefit from receiving the PPSV23 vaccination, even though they produce less IgG in response to it. These results can help clinicians to better schedule and evaluate pneumococcal vaccination for RA patients.
authors.affiliation: From the Japanese National Hospital Organization (NHO), Multi-center Clinical Studies for Evidence-based Medicine Study Group; Japanese Study of Randomized Controlled Study for Patients with RA Using 23-Valent Pneumococcal Polysaccharide Vaccine (RA-PPV23), Meguro, Tokyo (KM, ST, FH, HI, RM, ES, TM, SM, TF, YI, NI, YJ, HK, HT, KS, TY, SO, NM, AM, KK, KT, TO, NH, KN, HN, NT, YS, MK, TM, HF, KK); Research Institute for Microbial Diseases, Osaka University, Suita, Osaka (YA); Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Kiyose, Tokyo (MA); and Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan (KO).
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Akeda
authors.forename: Manabu
authors.initials: M
authors.lastname: Akazawa
authors.forename: Shigeto
authors.initials: S
authors.lastname: Tohma
authors.forename: Fuminori
authors.initials: F
authors.lastname: Hirano
authors.forename: Haruko
authors.initials: H
authors.lastname: Ideguchi
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Matsumura
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suematsu
authors.forename: Tomoya
authors.initials: T
authors.lastname: Miyamura
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Mori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Yasumori
authors.initials: Y
authors.lastname: Izumi
authors.forename: Nozomi
authors.initials: N
authors.lastname: Iwanaga
authors.forename: Yuka
authors.initials: Y
authors.lastname: Jiuchi
authors.forename: Hideko
authors.initials: H
authors.lastname: Kozuru
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsutani
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Saisyo
authors.forename: Takao
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Shiro
authors.initials: S
authors.lastname: Ohshima
authors.forename: Naoya
authors.initials: N
authors.lastname: Mori
authors.forename: Akinori
authors.initials: A
authors.lastname: Matsumori
authors.forename: Kiyoki
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Takahi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ozawa
authors.forename: Norikazu
authors.initials: N
authors.lastname: Hamada
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagai
authors.forename: Norio
authors.initials: N
authors.lastname: Tamura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suenaga
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kawabata
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Matsui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawakami
authors.forename: Kazunori
authors.initials: K
authors.lastname: Oishi
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000276:immunology; D000917:Antibody Formation / Q000187:drug effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology; D004311:Double-Blind Method; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000276:immunology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000276:immunology; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control*; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D022242:Pneumococcal Vaccines; C529000:golimumab; D008727:Methotrexate