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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Influenza A/H1N1 vaccination of patients with SLE: can antimalarial drugs restore diminished response under immunosuppressive therapy?

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Autor(es):
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Borba, Eduardo F. [1] ; Saad, Carla G. S. [1] ; Pasoto, Sandra G. [1] ; Calich, Ana L. G. [1] ; Aikawa, Nadia E. [1, 2] ; Ribeiro, Ana C. M. [1] ; Moraes, Julio C. B. [1] ; Leon, Elaine P. [1] ; Costa, Luciana P. [1] ; Guedes, Lissiane K. N. [1] ; Silva, Clovis A. A. [1, 2] ; Goncalves, Celio R. [1] ; Fuller, Ricardo [1] ; Oliveira, Suzimara A. [3] ; Ishida, Maria A. [4] ; Precioso, Alexander R. [5] ; Bonfa, Eloisa [1]
Número total de Autores: 17
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Fac Med, Div Rheumatol, BR-05403010 Sao Paulo - Brazil
[2] Univ Sao Paulo, Fac Med, Paediat Rheumatol Unit, BR-05403010 Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Med, Dept Pathol, BR-05403010 Sao Paulo - Brazil
[4] Univ Sao Paulo, Fac Med, Adolfo Lutz Inst, BR-05403010 Sao Paulo - Brazil
[5] Butantan Inst, Sao Paulo - Brazil
Número total de Afiliações: 5
Tipo de documento: Artigo Científico
Fonte: RHEUMATOLOGY; v. 51, n. 6, p. 1061-1069, JUN 2012.
Citações Web of Science: 26
Resumo

Objective. To assess the efficacy and safety of pandemic 2009 influenza A (H1N1) in SLE under different therapeutic regimens. Methods. A total of 555 SLE patients and 170 healthy controls were vaccinated with a single dose of a non-adjuvanted preparation. According to current therapy, patients were initially classified as SLE No Therapy (n = 75) and SLE with Therapy (n = 480). Subsequent evaluations included groups under monotherapy: chloroquine (CQ) (n = 105), prednisone (PRED) epsilon 20 mg (n = 76), immunosuppressor (IS) (n = 95) and those with a combination of these drugs. Anti-H1N1 titres and seroconversion (SC) rate were evaluated at entry and 21 days post-vaccination. Results. The SLE with Therapy group had lower SC compared with healthy controls (59.0 vs 80.0%; P < 0.0001), whereas the SLE No Therapy group had equivalent SC (72 vs 80.0%; P = 0.18) compared with healthy controls. Further comparison revealed that the SC of SLE No Therapy (72%) was similar to the CQ group (69.5%; P = 0.75), but it was significantly reduced in PRED epsilon 20 mg (53.9%; P = 0.028), IS (55.7%; P = 0.035) and PRED epsilon 20 mg + IS (45.4%; P = 0.038). The concomitant use of CQ in each of these later regimens was associated with SC responses comparable with SLE No Therapy group (72%): PRED epsilon 20 mg + CQ (71.4%; P = 1.00), IS + CQ (65.2%; P = 0.54) and PRED epsilon 20 mg + IS + CQ (57.4%; P = 0.09). Conclusion. Pandemic influenza A H1N1/2009 vaccine response is diminished in SLE under immunosuppressive therapy and antimalarials seems to restore this immunogenicity. (AU)

Processo FAPESP: 10/10749-0 - Vacina anti-influenza H1N1/2009 em pacientes com doenças reumáticas autoimunes
Beneficiário:Eloisa Silva Dutra de Oliveira Bonfá
Linha de fomento: Auxílio à Pesquisa - Regular