Objectives: Wegener’s granulomatosis (WG) is a systemic vasculitis characterized by relapsing and remitting disease activity. Immunosuppressive drugs are used to control disease, but increase susceptibility to infection. Therefore, influenza vaccination should be considered in WG patients. This study was performed to assess immunogenicity of influenza vaccination in WG patients.
Methods: We performed a randomized, controlled trial in WG patients with quiescent disease, defined as Birmingham Vasculitis Activity Score (BVAS) < 2. Patients were randomized to receive influenza vaccination (n = 49) or to participate as control (n = 23). In addition, healthy controls (n = 49) were vaccinated. At entry and at one and three to four months after entry, antibody responses to vaccination were determined. Furthermore, disease activity was measured (BVAS), adverse effects were recorded, and antineutrophil cytoplasmic autoantibodies (ANCA) titers were determined.
Results: WG patients achieved high seroprotection rates to all three influenza strains, comparable to healthy controls. Only for the A/H1N1 strain patients had a lower seroconversion rate (p = 0.002) and geometric mean titer (p = 0.037) than controls. After one month, one control and one vaccinated WG patient had developed active disease. At three to four months, two additional control patients had developed active disease versus none of the vaccinated patients (p = 0.099). Vaccination did not influence ANCA titers. Adverse effects did not differ between patients and healthy controls.
Conclusions: Influenza vaccination in WG patients with quiescent disease induced a sufficient antibody response. Dutch Trial Register, NTR1130.