Background Hepatitis B vaccination is recommended for rheumatoid arthritis (RA) patients in many international guideline. However, the short-term and long-term efficacies of hepatitis B vaccination in RA patients that recieved conventional and/or biological disease-modifying anti-rheumatic drugs (cDMARDs and/or bDMARDs) are not clearly established.
Objectives To assess the long term of immunogenicity of the hepatitis B vaccination in rheumatoid arthritis (RA) patients receiving cDMARDs and/or bDMARDs.
Methods The study comprised 45 patients with RA, of whom 33 received cDMARDs and 12 received bDMARDs therapy (study group), and 9 subjects with age- and sex-matched healthy controls (control group). All subjects were vaccinated with 20 μg of recombinant hepatitis B vaccine (Euvax B®) at weeks 0, 4, and 24. Blood samples were collected 8 weeks and 12 months after receipt of the third vaccine dose to test for antibody to hepatitis B surface antigen (anti-HBs). Responders (seroprotection) were defined as anti-HBs level ≥10 mIU/mL. The study was approved by the ethic committee and institutional review board.
Results Baseline characteristics of study and control groups were similar. Patients receiving cDMARDs tended to has lower proportion of seroprotection than control group (69.7% vs 100%, p=0.09) at 2 months and (57.57% vs 100%, p=0.016) 12 months after receipt of the third vaccine dose. Patients receiving bDMARDs had a significantly lower proportion of seroprotection compared with control group (50% vs 100%, p=0.02) at both 8 weeks and 12 months after receipt of the third vaccine dose. The proportion of seroprotection is significantly decreased between 2 months and 12 months in patients receiving cDMARDs (69.7% vs 57.57%, p=0.044) after completion of the third dose vaccine.
Conclusions DMARDs both conventional and biological DMARDs therapy impaired short-term and long-term immunogenic response to hepatitis B vaccine.
Disclosure of Interest None declared
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