AB0403 EVALUATION OF THE SAFETY AND EFFICACY OF 13-VALENT PNEUMOCOCCAL VACCINE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

BackgroundRheumatoid arthritis (RA) is accompanied by a significant increase in the risk of infection and serious infections, among which pneumonia occupies a leading place. (1) The use of targeted anti-inflammatory drugs is accompanied by an additional increase in the risk of infectious complications. In this regard, vaccination is crucial in the management of such patients.ObjectivesTo evaluate the safety and efficacy of the 13-valent pneumococcal vaccine in patients with RA undergoing various types of antirheumatic therapy.MethodsThe study included 60 patients with a reliable diagnosis of RA, according to the criteria of ACR/EULAR, among them 8 men and 52 women, average age 63 years (from 29 to 69 years) with disease activity at the time of inclusion of Das-28 – 4.9 (2.2-7.7), bionaive patients with insufficient response to DMARDs who will be prescribed tofacitinib (TOFA) for the first time or receiving TOFA for at least 3 months (30 patients in each group). Both groups of patients were further subdivided into two groups, 15 vaccinated and unvaccinated patients in each. The exclusion criteria were: age over 70 years; patients with infectious diseases in the acute stage; having a history of intolerance to diphtheria toxoid, patients who had previously been vaccinated with pneumococcal vaccines. For the prevention of pneumococcal infection, a pneumococcal 13-valent polysaccharide conjugated adsorbed vaccine was used. Visits to assess the condition were made in the period of 0-3-12 months. The activity of the disease was assessed by the DAS 28, CDAI, SDAI indices.ResultsAmong vaccinated patients with PCV 13 the most common adverse events were: pain at the injection site (16%), fever up to 37.6C (13%), redness at the injection site (6%), infiltration at the injection site (2%), myalgia (2%). These adverse events resolved spontaneously within 3 days. In a comparative assessment of infectious events during 12 months before vaccination and the next 12 months after it, there were no significant differences between vaccinated and unvaccinated patients. In patients who had a history of pneumococcal etiology infections after vaccination, the incidence decreased by 33%.ConclusionVaccination against pneumococcal infection is a safe and effective method of preventing pneumococcal infection in patients with rheumatoid arthritis.References[1]Koivuniemi R., Leirisalo-Repo M., Suomalainen R., etc. Infectious causes of death in patients with rheumatoid arthritis: an autopsy study. Scand J Rheumatol 2006; 35)4): 273-6Disclosure of InterestsGalina Lukina Speakers bureau: Ebbvie, Biocad, Pfizer, Roche, Dzhamilya Murtazalieva: None declared, Ekaterina Koltsova: None declared, Mikhail Kostinov: None declared, Anna Shmitko: None declared, Dmitry Blagovidov: None declared, Evgeniy Zhilyaev Speakers bureau: Ebbvie, Biocad, Pfizer, Roche