Serologic immunogenicity and safety of herpes zoster subunit vaccine in patients with rheumatoid arthritis receiving Janus kinase inhibitors
Authors' conclusion
The HZ/su vaccine was serologically immunogenic in most RA patients treated with JAKi. Moreover, the vaccine had an acceptable safety profile.
Study context
- Population
- RA patients treated with JAKi, Department of Rheumatology, Skåne University Hospital, Lund and Malmö, Sweden, and healthy controls
- Participants
- 82 vs 51
- Exposure
- RA patients on JAKi vs healthy controls, both receiving two doses of herpes zoster (HZ)/su vaccine (Shingrix)
- RA on JAKin = 82
- Healthy controlsn = 51reference
- Outcome
- Serological immunogenicity (vaccine-specific antibody responses by indirect ELISA) of HZ/su vaccine
Methodological detailssingle-centre, healthy controls, analysis of covariance, multivariable linear regression
- Single-centre
- Healthy controls
- Analysis of covariance
- Multivariable linear regression
Main finding
As reported in the abstract
Post-vaccination vaccine-specific antibody levels; ≥4-fold increase in antibody levels
Ratio
0.44
95% CI 0.31–0.63
By group
- Antibody levels increased significantly in both patients and controls following vaccination
- P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | Ratio (95% CI) |
|---|---|
| Post-vaccination antibody levels, JAKi + MTX vs JAKi monotherapy (subgroup)Lower with JAKi + MTX | 0.43 (0.24–0.79) |
Safety
| Outcome | Values |
|---|---|
| Increased RA disease activity following vaccination | Patients 6.5% |
| HZ after vaccination | Patients 1 events |
Adverse events (AEs)
- AEs, mostly mild/moderate, were common
Original publication
Serologic immunogenicity and safety of herpes zoster subunit vaccine in patients with rheumatoid arthritis receiving Janus kinase inhibitors. Rheumatology (Oxford). Published 18 October 2023. doi:10.
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