FRI0461 THE ANTI-VACCINE ANTIBODY AGAINST MEASLES, PAROTITIS, RUBELLA, DIPHTHERIA AND HEPATITIS B IN 170 JUVENILE IDIOPATHIC ARTHRITIS PATIENTS

Abstract

Background:Patients with juvenile idiopathic arthritis (JIA) may have lower protective levels of anti-vaccine antibodies due to high inflammatory activity, interrupted or incomplete vaccination schedule, and due to using of immune-modulating drugs, e.g. systemic corticosteroids (CS), methotrexate (MTX) and biologics.Objectives:The aim of our study was to find the predictors of low levels of anti-vaccine antibodies in patients with JIA.Methods:In the present study were included data 170 JIA (55 boys and 115 girls) aged from 2 to 17 years, who received scheduled vaccination before the age of 2 years and before JIA onset against measles, parotitis, hepatitis B, diphtheria and rubella. In all patients the Ig G anti-vaccine antibodies levels were detected with ELISA. In each patient we evaluate the type of the disease (oligoarthritis - 73, polyarthritis - 61, systemic-16 and enthesitis-related arthritis - 20), onset age, presence of uveitis, duration of JIA, treatment with corticosteroids (CS), methotrexate (MTX) and biologics. Data presented with median and 25%-75%.Results:The main demographic characteristics: age of inclusion in the study 11.4 (7.6-14.8) years, disease onset – 6.0 (3.7-9.0) years, disease duration – 3.8 (1.9-6.5) years. Treatment with CS was in 43 (25.3%), MTX in 154 (90,6%) and biologics 82 (48.2%) patients, among them 53 had TNFa-inhibitors. More than 1 biologic consequently received 16/82 (19.5%) patients. Protective levels of anti-measles antibodies was in 98 (57,6%) of all JIA population, anti-parotitis – 136 (80.0%), anti-hepatitis B – 85 (50.0%), anti-diphtheria – 88 (51,7%), anti-rubella – 167 (98.8%). Data of vaccination status and anti-vaccine antibodies levels in the table. In univariate and multivariate regression analysis the main risk factors for anti-measles antibodies levels were MTX using (p=0.045), more than 1 biologics (p=0.0004); for anti-hepatitis B – MTX (p=0.03), for anti-diphtheria antibodies: onset age (p=0.0002), JIA duration (p=0.00007), number vaccine doses (p=0.02), more than 1 biologics (p=0.01); combined treatment with biologics and other drugs (MTX or CS).ParameterNo treatment (n=14)MTT, only(n=74)Biologics±MTT±CS (n=82)P# anti-measels vaccine doses2.0 (2.0; 2.0)2.0 (1.0; 2.0)2.0 (1.0; 2.0)0.19Anti-measels IgG, Me/ml0.28 (0.1; 0.6)0.4 (0.1-0.7)0.17 (0.0; 0.29)0.0002Protective anti-measels IgG level, n (%)8 (57)50 (68)40 (49)0.06# anti-parotitis vaccine doses2.0 (2.0; 2.0)2.0 (1.0; 2.0)2.0 (1.0; 2.0)0.19Anti-parotitis IgG, Me/ml2.0 (1.2; 4.3)2.8 (1.3; 5.6)2.5 (1.0; 5.1)0.47Protective anti-parotitis IgG level, n (%)12 (86)62 (84)62 (76)0.38# anti-diphtheria vaccine doses5.0 (4.0; 5.0)4.0 (4.0; 5.0)5.0 (4.0; 5.0)0.39Anti-diphtheria IgG, Me/ml0.17 (0.0; 1.2)0.18 (0.0; 0.4)0.1 (0.0; 0.2)0.18Protective anti-diphtheria IgG level, n (%)9 (64)42 (57)37 (45)0.22# anti-hepatitis B vaccine doses3.0 (3.0; 3.0)3.0 (3.0; 3.0)3.0 (3.0; 3.0)0.91Anti-hepatitis B IgG, Me/ml0.56 (0.0; 7.5)11.4 (0.3; 44.8)10.0 (0.0; 44.1)0.08Protective anti-hepatitis B IgG level, n (%)3 (21)40 (54)42 (51)0.08# anti-rubella vaccine doses2.0 (2.0; 2.0)2.0 (1.0; 2.0)2.0 (1.0; 2.0)0.19Anti-rubella IgG, Me/ml121.8(70.0; 200.0)95.6(53.3; 198.2)56.4(37.0; 100.1)0.008Protective anti-rubella IgG level, n (%)14 (100)73 (100)80 (98)0.34Conclusion:MTX, biologics and JIA durations are factors influenced on anti-vaccine antibody level. It is necessary to regularly check the levels of anti-vaccine antibodies, especially anti-measels and anti-diphtheria for creation of the individual vaccination plan for JIA patients, treated with MTX and biologics.Disclosure of Interests:None declared