Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Autoantibody Response to Adjuvant and Non-Adjuvant H1N1 Vaccination in SLE.
Urowitz, Murray B., Anton, Anoja, Ibanez, Domonique, Gladman, Dafna D.
It has been reported that influenza vaccination increases autoantibody production and/or disease activity in a significant proportion of patients with SLE. A further concern would be whether adjuvant containing vaccinations might further enhance autoantibody production in these patients. During the recent H1N1 epidemic we investigated whether the use of adjuvant and nonadjuvant containing H1N1 vaccine induced increased authoantibody production in patients with SLE.
Patients with SLE who received H1N1 vaccination (with or without adjuvant) and had a battery of 9 autoantibodies tested before and 1 and 3 months after vaccination were included. Antibodies tested included rheumatoid factor (nephelometry), antinuclear antibody (immunofluorescence), anti-DNA (Farr), anti-RNP, anti-SM, anti-Ro, anti-La, anti-Scl70 and anti-Jo1 (ELISA). Patients were evaluated according to the standard protocol including items necessary to calculate SLEDAI-2K and SDI. Descriptive statistics and McNemar test were performed to evaluate change in antibodies positivity. These were repeated in the adjuvant and the non adjuvant groups separately.
103 patients (94F, 9M), with mean age at vaccination of 43.9 (±15.2) years, disease duration 14.2 (±11.0) years. Mean SLEDAI-2K was 4.38 (±4.28), SDI of 1.26 (±1.52). 64% were taking steroids and 62% on immunosuppressives. 51 patients received adjuvant and 52 nonadjuvant vaccines. Antibody testing was performed a mean of 1.9 months prior to the vaccination. First post-vaccination sample was taken a mean of one month and the second sample was taken a mean of 3.5 months after vaccination. The percent of patients with changes in antibodies following vaccination was not statistically significant for most antibodies. In rheumatoid factor 80% remained unchanged while 15% who were negative became positive while 5% who were positive became negative (p=0.07). This was more pronounced in the non adjuvant group then in the adjuvant group where 88% remained unchanged, 12% converted for positive and none converted to negative compared to 71% remaining unchanged, 18% converting to positive and 12% converting to negative (p=0.03 and p=0.53 respectively). In Anti-Ro 83% remained unchanged while 3% converted to positive and 14% converted to negative(p=0.03) but no difference was significant when looking at the vaccine type. No other antibodies changes significantly in either group. After adjusting for the number of tests performed none of the associations was significant.
H1N1 vaccination (both adjuvant and non adjuvant) did not increase the levels of autoantibodies in patients with SLE.
To cite this abstract, please use the following information:
Urowitz, Murray B., Anton, Anoja, Ibanez, Domonique, Gladman, Dafna D.; Autoantibody Response to Adjuvant and Non-Adjuvant H1N1 Vaccination in SLE. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :450