Pneumococcal vaccinations help to protect patients with rheumatoid arthritis against serious pneumococcal infections of the lungs, brain, blood, and ears , according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Antonio, Texas.
Rheumatoid arthritis patients have an approximately two-fold increased morbidity and mortality in infections compared to a population without the disease. Consequently, potential infections resulting from pneumococcal disease can loom as life threatening. Previous studies of the influenza vaccination program in the U.S. and vaccination against pneumococcus have indicated immunization does not worsen the disease in patients with rheumatoid arthritis, but the safety of the immunization had not been tested in these patients. Additionally, there was concern that patients with rheumatoid arthritis would not respond to pneumococcal vaccinations because of the effects of the disease or the treatments used for the disease on the ability of the body's immune system to respond to the vaccination.
Researchers monitored 149 patients with established rheumatoid arthritis and 47 patients without arthritis for effects generated by pneumococcal vaccinations, inoculating each patient with a standard dosage of commercially available vaccine. Of the 149 rheumatoid arthritis patients, 50 were taking methotrexate and either etanercept (Enbrel ®) or infliximab (Remicade ®) TNF-blockers . TNF-blockers reduce the action of proteins in the body that can contribute to inflammation and joint damage. Of the remaining rheumatoid arthritis patients, 62 were on TNF-blocker therapy alone or with some other disease-modifying anti-rheumatic drugs (DMARDs), and 37 were taking methotrexate only. The four groups were measured for antibodies associated with invasive infections prior to and four to six weeks after vaccination.