Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus

The aim of the work is to study the immunogenicity, tolerability, and clinical efficacy of the 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE). Material and methods. The study included 61 patients with a confirmed diagnosis of SLE, including...

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Main Authors: G. M. Tarasova, B. S. Belov, M. V. Cherkasova, S. K. Soloviev, E. A. Aseeva, T. M. Reshetnyak, T. V. Popkova, N. M. Kosheleva
Format: Article
Language:Russian
Published: LLC "Publishing House OKI" 2020-08-01
Series:Антибиотики и Химиотерапия
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Online Access:https://www.antibiotics-chemotherapy.ru/jour/article/view/738
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author G. M. Tarasova
B. S. Belov
M. V. Cherkasova
S. K. Soloviev
E. A. Aseeva
T. M. Reshetnyak
T. V. Popkova
N. M. Kosheleva
author_facet G. M. Tarasova
B. S. Belov
M. V. Cherkasova
S. K. Soloviev
E. A. Aseeva
T. M. Reshetnyak
T. V. Popkova
N. M. Kosheleva
author_sort G. M. Tarasova
collection DOAJ
description The aim of the work is to study the immunogenicity, tolerability, and clinical efficacy of the 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE). Material and methods. The study included 61 patients with a confirmed diagnosis of SLE, including 53 women, 8 men, aged 19 to 68 years. The disease activity at the time of vaccination: in 9 patients — high, in 13 — medium, in 34 — low, in 5 — remission. Therapy outline: 59 patients received glucocorticoids (GC) 5–30 mg/day in terms of prednisolone, 45 — hydroxychloroquine (GC), 33 — cytostatics (CS), 22 — genetically engineered biological drugs (GEBD): 11 — rituximab (RTM), 10 — belimumab (BLM). 23-valent polysaccharide pneumococcal vaccine in an amount of 0.5 ml (1 dose) was injected subcutaneously. Follow-up period: 9 patients — 3 months, 52 — 1 year after the vaccination. Patients were examined before vaccination, as well as in 1, 3, and 12 months after the vaccination. Results and discussion. After a year of observation, the number of «responders» to vaccination was 61.5%, «non-responders» — 38.5%. There was a decreased response to vaccine in patients receiving GEBD compared with patients who did not receive GEBD (40% and 75%, respectively), p=0.02. No differences were found against the background of RTM and BLM therapy. Administering GC in a dose exceeding 10 mg/day did not lead to a more significant decrease in response to vaccine compared to other patients. Standard local vaccination reactions of mild to moderate severity were noted in 50.8% of the patients, general reaction of mild severity — in 1 patient (1.6%), hyperergic Arthus-like reaction — in 1 patient (1.6%), the symptoms of which were relieved in 7 days. During the observation period (1 year), not a single case of exacerbation of SLE, reliably associated with the vaccination, was registered, and no new autoimmune phenomena were identified. Clinically positive dynamics was noted in the form of a decrease in the number of episodes of pneumonia, as well as acute and exacerbated chronic bronchitis, sinusitis. Conclusion. Sufficient immunogenicity, good tolerance, and clinical effectiveness of PPV-23 in patients with SLE, incl. those, who received combined immunosuppressive therapy. Further studies are needed in large groups of patients with long follow-up periods.
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spelling doaj-art-e2902b05bee04265b4c5203a1755c09b2025-08-20T03:20:32ZrusLLC "Publishing House OKI"Антибиотики и Химиотерапия0235-29902020-08-01655-6354010.37489/0235-2990-2020-65-5-6-35-40728Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus ErythematosusG. M. Tarasova0B. S. Belov1M. V. Cherkasova2S. K. Soloviev3E. A. Aseeva4T. M. Reshetnyak5T. V. Popkova6N. M. Kosheleva7Scientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationScientific Research Institute of Rheumatology named after V. A. Nasonova of the Ministry of Health of the Russian FederationThe aim of the work is to study the immunogenicity, tolerability, and clinical efficacy of the 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE). Material and methods. The study included 61 patients with a confirmed diagnosis of SLE, including 53 women, 8 men, aged 19 to 68 years. The disease activity at the time of vaccination: in 9 patients — high, in 13 — medium, in 34 — low, in 5 — remission. Therapy outline: 59 patients received glucocorticoids (GC) 5–30 mg/day in terms of prednisolone, 45 — hydroxychloroquine (GC), 33 — cytostatics (CS), 22 — genetically engineered biological drugs (GEBD): 11 — rituximab (RTM), 10 — belimumab (BLM). 23-valent polysaccharide pneumococcal vaccine in an amount of 0.5 ml (1 dose) was injected subcutaneously. Follow-up period: 9 patients — 3 months, 52 — 1 year after the vaccination. Patients were examined before vaccination, as well as in 1, 3, and 12 months after the vaccination. Results and discussion. After a year of observation, the number of «responders» to vaccination was 61.5%, «non-responders» — 38.5%. There was a decreased response to vaccine in patients receiving GEBD compared with patients who did not receive GEBD (40% and 75%, respectively), p=0.02. No differences were found against the background of RTM and BLM therapy. Administering GC in a dose exceeding 10 mg/day did not lead to a more significant decrease in response to vaccine compared to other patients. Standard local vaccination reactions of mild to moderate severity were noted in 50.8% of the patients, general reaction of mild severity — in 1 patient (1.6%), hyperergic Arthus-like reaction — in 1 patient (1.6%), the symptoms of which were relieved in 7 days. During the observation period (1 year), not a single case of exacerbation of SLE, reliably associated with the vaccination, was registered, and no new autoimmune phenomena were identified. Clinically positive dynamics was noted in the form of a decrease in the number of episodes of pneumonia, as well as acute and exacerbated chronic bronchitis, sinusitis. Conclusion. Sufficient immunogenicity, good tolerance, and clinical effectiveness of PPV-23 in patients with SLE, incl. those, who received combined immunosuppressive therapy. Further studies are needed in large groups of patients with long follow-up periods.https://www.antibiotics-chemotherapy.ru/jour/article/view/738systemic lupus erythematosuspneumoniavaccination23-valent polysaccharide pneumococcal vaccineimmunosuppressive therapygenetically engineered biological drugs
spellingShingle G. M. Tarasova
B. S. Belov
M. V. Cherkasova
S. K. Soloviev
E. A. Aseeva
T. M. Reshetnyak
T. V. Popkova
N. M. Kosheleva
Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
Антибиотики и Химиотерапия
systemic lupus erythematosus
pneumonia
vaccination
23-valent polysaccharide pneumococcal vaccine
immunosuppressive therapy
genetically engineered biological drugs
title Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
title_full Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
title_fullStr Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
title_full_unstemmed Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
title_short Immunogenicity, Tolerability, and Clinical Effectiveness of 23-Valent Polysaccharide Pneumococcal Vaccine in Patients with Systemic Lupus Erythematosus
title_sort immunogenicity tolerability and clinical effectiveness of 23 valent polysaccharide pneumococcal vaccine in patients with systemic lupus erythematosus
topic systemic lupus erythematosus
pneumonia
vaccination
23-valent polysaccharide pneumococcal vaccine
immunosuppressive therapy
genetically engineered biological drugs
url https://www.antibiotics-chemotherapy.ru/jour/article/view/738
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