PT  - JOURNAL ARTICLE
AU  - A Holvast
AU  - C A Stegeman
AU  - C A Benne
AU  - A Huckriede
AU  - J C Wilschut
AU  - A M Palache
AU  - C G M Kallenberg
AU  - M Bijl
TI  - Wegener’s granulomatosis patients show an adequate antibody response to influenza vaccination
AID  - 10.1136/ard.2008.092924
DP  - 2009 Jun 01
TA  - Annals of the Rheumatic Diseases
PG  - 873--878
VI  - 68
IP  - 6
4099  - http://ard.bmj.com/content/68/6/873.short
4100  - http://ard.bmj.com/content/68/6/873.full
SO  - Ann Rheum Dis2009 Jun 01; 68
AB  - Objectives: Wegener’s granulomatosis (WG) is a systemic vasculitis characterised 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 the immunogenicity of influenza vaccination in WG patients.Methods: A randomised, controlled trial was performed in WG patients with quiescent disease, defined as a Birmingham vasculitis activity score (BVAS) less than 2. Patients were randomly assigned to receive influenza vaccination (n  =  49) or to participate as controls (n  =  23). In addition, healthy controls (n  =  49) were vaccinated. At entry and at 1 and 3–4 months after entry, antibody responses to vaccination were determined. Furthermore, disease activity was measured (BVAS), adverse effects were recorded and antineutrophil cytoplasmic autoantibody (ANCA) titres were determined.Results: WG patients achieved high seroprotection rates to all three influenza strains, comparable with healthy controls. Only the A/H1N1 strain patients had a lower seroconversion rate (p = 0.002) and geometric mean titre (p = 0.037) than controls. After 1 month, one control and one vaccinated WG patient had developed active disease. At 3–4 months, two additional control patients had developed active disease compared with none of the vaccinated patients (p = 0.099). Vaccination did not influence ANCA titres. Adverse effects did not differ between patients and healthy controls.Conclusions: Influenza vaccination in WG patients with quiescent disease induced a sufficient antibody response.Trial registration number: NTR1130.