TY - JOUR T1 - Safety and efficacy of influenza vaccination in systemic lupus erythematosus patients with quiescent disease JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 913 LP - 918 DO - 10.1136/ard.2005.043943 VL - 65 IS - 7 AU - A Holvast AU - A Huckriede AU - J Wilschut AU - G Horst AU - J J C De Vries AU - C A Benne AU - C G M Kallenberg AU - M Bijl Y1 - 2006/07/01 UR - http://ard.bmj.com/content/65/7/913.abstract N2 - Objective: to assess the safety and efficacy of influenza vaccination in patients with systemic lupus erythematosus (SLE), and to evaluate the influence of immunosuppressive drugs on the immune response.Methods: SLE patients (n = 56) and healthy controls (n = 18) were studied. All patients had quiescent disease (SLE disease activity index ⩽5). Four patient groups were defined on the basis of their drug use: (1) no drug treatment; (2) hydroxychloroquine treatment; (3) azathioprine treatment; (4) prednisone treatment. Participants received trivalent influenza subunit vaccine during October/November 2003. Disease activity scores and side effects were recorded. Antibody titres against influenza virus were measured before and 30 days after vaccination using the haemagglutination inhibition assay.Results: Influenza vaccination did not result in changes in disease activity and was well tolerated. SLE patients had fewer seroconversions or fourfold titre rises for A/H1N1 (p<0.001) and A/H3N2 (p<0.001) than healthy controls, while for B/Hong Kong the difference was of borderline significance (p = 0.051). With regard to immunosuppressive treatment, fewer SLE patients using azathioprine developed fourfold titre rises against A/H3N2 (p = 0.041), and fewer achieved titres of ⩾40 against A/H3N2 (p = 0.030) compared with the other patient groups.Conclusions: Influenza vaccination in SLE patients with quiescent disease is safe but is less effective than in controls. Use of azathioprine was associated with a trend to decreased vaccination efficacy. ER -