A Brazilian hospital-based study assessed responses to flu vaccines in 340 RA patients in regular follow-up compared to 234 healthy patients. Measures of protection obtained by vaccination (seroprotection rate (SP)) after immunization was over 20% lower for RA patients compared to healthy individuals (60.1% vs. 82.9% comparatively (p<0.001)). Tests to determine levels of detectable antibodies to microorganisms in the blood serum as a result of infection and immunization with the flu virus (seroconversion rate (SC)) showed a similar pattern with 53.4% of RA patients and 76.9% of healthy controls having antibodies present respectively (p<0.001).
"This study has highlighted that there are differences in the level of protection between the H1N1 vaccine and the seasonal influenza vaccine so healthcare professionals should not assume that immune response will be the same with different vaccines" said Professor A. Ribeiro of the University of Sao Paolo. "In planning for future pandemic outbreaks, healthcare professionals should consider specific immunization strategies to ensure this large population of patients are as fully protected as possible from the risk of contracting pandemic flu."
The vaccination's impact on disease activity (DAS28*) was also measured and nine patients (2.6%) reported worsening of symptoms with the mean disease activity score changing from 3.66 to 5.15 (p<0.05) after the H1N1 vaccination. No serious adverse events were seen across either patient group, although more subjects in the RA patient group reported more adverse events, 42% versus 30.8% with a rate of 140 events/100 patients versus 87/100 control group (p<0.005).
* DAS28 (Disease Activity Score) is an index used by physicians to measure how active an individual's RA is. It assesses number of tender and swollen joints (out of a total of 28), the ethroycyte sedimentation rate (ESR, a blood marker of inflammation), and the patient's 'global assessment of global health'. A higher score indicates more active disease.
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The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations. In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems. The aims of EULAR are to stimulate, promote, and support the research, prevention, treatment and rehabilitation of rheumatic diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with rheumatic diseases. Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer. EULAR 2011 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 100 countries. Over the course of the congress, almost 300 oral and more than 1600 poster abstract presentations will be featured, with 300 invited speaker lectures taking place in more than 140 sessions. To find out more about the activities of EULAR, visit: www.eular.org