THU0541 ANTI-VACCINE ANTIBODY LEVELS IN JUVENILE IDIOPATHIC ARTHRITIS PATIENTS: PRELIMINARY DATA IN 90 PATIENTS

Abstract

Background Patients with juvenile idiopathic arthritis (JIA) may have lower protective levels of anti-vaccine antibodies (AVA) due to high inflammatory activity, interrupted or incomplete vaccination schedule, using of immune-modulating drugs, e.g. systemic corticosteroids (CS), methotrexate (MTX) and biologics [1]. Objectives The aim of our study was to evaluate levels of AVA in the patients with JIA. Methods We included data about 90 JIA (26 M and 64 F) aged from 2 to 17 years, who received scheduled vaccination before the age of 2 years and before JIA onset. In all patients the Ig G anti-measles (AM), anti-parotitis (AP), anti-hepatitis B (AHB), anti-diphtheria (AD) and anti-rubella (AR) AVA levels were detected with ELISA. In each patient we evaluate the type of the JIA (oligoarthritis – OA (n=38), polyarthritis – PA (n=36), systemic-SA (n=7) and enthesitis-related arthritis – ERA (n=10), routine disease activity and treatment. In healthy controls were measured anti-measles (n=40) and anti-parotitis (n=30) antibodies (AB) for comparison with JIA. Results The main demographic characteristics: age of inclusion in the study 11 (8-15) years, disease onset–6 (4-8) years, JIA duration–4 (2-7) years. The AM AB in JIA patients were 0.2 (0.0-0.5) IU/ml and in HC 0.3 (0.2-1.1) IU/ml (p=0.00002), despite the higher age of JIA patients than HC (p=0.0000001); AP AB were 2.6 (1.0-5.1) IU/ml vs 1.1 (0.0-4.9) IU/ml in JIA and HC, respectively (p=0.08). Protective levels of AM AB was detected in 50% of all JIA population, vs. HC – 87.5% (p=0.00005), AP–67.7% vs. 60% in HC (p=0.076), AHB – 54.4%, AD–50%, AR–97.8%. The main data related to vaccination status in the table. We have found correlation between JIA duration and levels AM AB (r=-0.27, p=0.015), AP AB (r=-0.22, p=0.039), AD AB (r=-0.27, p=0.015); MTX treatment with AM AB (r=-0.37, p=0.001), and AD AB (r=-0.29, p=0.007); treatment with biologics and AM AB (r=-0.25, p=0.018), and using more than one biologics with AR AB (r=-0.27, p=0.047). In the regression model only MTX had a negative impact on AM (r=-0.001) and AD AB level (p=0.01). Conclusion Children with JIA are in the risk of decreased level of AVA, especially in measles, diphtheria and parotitis. The measurements of AVA in the individual JIA vaccination schedule required.