Immunogenicity to herpes zoster recombinant subunit vaccine in immune-mediated rheumatic patients under treatment with JAK inhibitors
Authors' conclusion
In these patients we have observed a broad impact on the adaptive humoral and cellular immune responses, suggesting a potential reduction in protection against HZ infection and VZV reactivation.
Study context
- Population
- Patients with immune-mediated rheumatic diseases (IMRDs) treated with JAKi receiving a two-dose regimen of the recombinant inactive herpes zoster (HZ) vaccine
- Exposure
- IMRD patients treated with JAKi vs matched healthy controls, after two-dose recombinant HZ vaccine
- IMRD on JAKin = 43
- Outcome
- Humoral and cellular CD4 and CD8 immune responses to the vaccine
Methodological detailsage, gender and disease-matched healthy controls
- Age, gender and disease-matched healthy controls
Main finding
As reported in the abstract
Seroconversion rate
Observational data: associations, not effects.
Further findings
| Outcome | IMRD on JAKi | Healthy controls | P value |
|---|---|---|---|
| VZV IgG titres | 1222 ± 411 | 3048 ± 556 | P < 0.0001 |
Functional T CD4 (IL-2 plus IFN-γ) and T CD8 (granzyme A and/or B) responses
- Significantly diminished in IMRD patients
Correlates of VZV antibody titres
- Negative correlation with age, specific treatments (baricitinib, tofacitinib, upadacitinib), cumulative MTX and GC doses, history of multiple DMARDs and JAKi treatment duration
- Functional T-CD4 but not T-CD8 responses showed similar negative correlations
- Positive associations between functional T-CD4 and T-CD8 responses
Original publication
Immunogenicity to herpes zoster recombinant subunit vaccine in immune-mediated rheumatic patients under treatment with JAK inhibitors. Rheumatology (Oxford). Published 24 October 2024. doi:10.
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