Rheumatoid Arthritis Clinical Trial
Official title:
Effects of Different Anti-rheumatic Treatments of Arthritis on Antibody Response Following Pneumococcal Vaccination Using Prevenar®
Previous studies have analyzed serological responses following pneumococcal vaccination using
23-valent vaccination (Pneumovax) in Rheumatoid Arthritis (RA) patients that were on
different therapeutic modalities including TNF-blockers and methotrexate. The results have
shown that serological response was significantly reduced in RA patients receiving
methotrexate compared to those receiving TNF-blockers.
In contrast when using polypeptide immunisation (influenza vaccine) we found that anti-TNF
significantly impaired the serological response compared to the methotrexate treated RA
patients. The aim of this study is to analyze serological responses after Prevenar
vaccination in patients with chronic arthritis and to study the impact of different treatment
modalities on serological responses.
It will be of interest to see if the result is different compared to the one seen after
immunizing with 23-valent nonconjugated pneumococcal polysaccharide vaccine.
Background: Previous studies have analyzed serological responses following pneumococcal
vaccination using 23-valent vaccination (Pneumovax) in Rheumatoid Arthritis (RA) patients
that were on different therapeutic modalities including TNF-blockers and methotrexate. The
results have shown that serological response was significantly reduced in RA patients
receiving methotrexate compared to those receiving TNF-blockers (Rheumatology (Oxford) 2006
Jan; 45(1):106-11).
In contrast when using polypeptide immunisation (influenza vaccine) we found that anti-TNF
significantly impaired the serological response compared to the methotrexate treated RA
patients.
The aim of this study is to analyze serological responses after PREVENAR vaccination in
patients with RA or spondylarthropathy and to study the impact of different treatment
modalities on serological responses.
It will be of interest to see if the result is different compared to the one seen after
immunizing with 23-valent nonconjugated pneumococcal polysaccharide vaccine.
Study design:
Unblinded study in RA patients and patients with spondylarthropathies. All subjects will be
vaccinated once with Prevenar and the serological response will be followed by blood draws.
Patient Population to be Included:
RA patients on methotrexate and/or other DMARDS RA patients on anti-TNF drugs as monotherapy
RA patients on anti-TNF +MTX and/or other DMARDSs Spondylarthropathy patients on anti-TNF
drugs as monotherapy Spondylarthropathy patients on anti-TNF drugs +MTX Spondylarthropathy
patients on NSAIDs (There is a possibility to stratify for steroid use).
Primary and Secondary Efficacy Endpoints:
Serological responses to at least 2 pneumococcal serotypes included in Prevenar vaccine
between different treatment groups.
An ethical approval from the Ethical Review Board at Lund University is mandatory for this
study as well as an approval from the Swedish MPA.
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