Вопросы современной педиатрии (Jan 2018)

Immunization With a Pneumococcal Polysaccharide Vaccine in Children With Juvenile Idiopathic Arthritis Without Systemic Manifestations: a Prospective Study

  • Ekaterina I. Alexeeva,
  • Tatiana M. Dvoryakovskaya,
  • Rina V. Denisova,
  • Ksenia B. Isaeva,
  • Margarita A. Soloshenko,
  • Anna V. Mamutova,
  • Nikolay A. Mayansky,
  • Natalia E. Tkachenko,
  • Irina V. Zubkova,
  • Tatiana A. Kaluzhnaya,
  • Firuza Ch. Shakhtakhtinskaya,
  • Anna G. Gayvoronskaya,
  • Marika I. Broeva,
  • Marina V. Fedoseenko

DOI
https://doi.org/10.15690/vsp.v16i6.1822
Journal volume & issue
Vol. 16, no. 6
pp. 493 – 501

Abstract

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Background. Patients with juvenile idiopathic arthritis (JIA) have an increased risk of being infected. Approximately half of all serious infections in children with JIA are associated with airway involvement.Objective. Our aim was to study the efficacy and safety of the pneumococcal 13-valent conjugate vaccine (PCV) in children with JIA.Methods. In a prospective cohort study, 5 groups were formed: children with JIA in the remission phase on methotrexate therapy (group 1) or etanercept (group 2), with JIA in the active phase prior to the appointment of methotrexate (group 3) or etanercept (group 4), control group (conditionally healthy children). 0.5 ml of the 13-valent PCV was administered once subcutaneously during therapy in patients in the remission phase or 3 weeks before the appointment of methotrexate or etanercept in patients in the active phase. The main study outcome was the proportion of patients with a protective ( 40 mg/L) level of specific anti-pneumococcal antibodies (anti-SPP) IgG to Streptococcus pneumoniae 4 weeks after vaccination. In addition, we assessed the incidence of infectious events before and after vaccination as well as changes in the content of a high-sensitivity C-reactive protein, S100 protein, and post-vaccination period.Results. The study included 125 children. Four weeks after vaccination, the protective level of anti-SPP IgG was established in 21 (84%) patients in the 1st, 23 (92%) in the 2nd, 22 (88%) in the 3rd, 24 (96%) in the 4th and 5th groups (p =1.0). Increase in the concentration of S100 protein and high-sensitivity C-reactive protein after vaccination was not noted. JIA exacerbation episodes were not recorded in any patient. After immunization, the total number of infectious events decreased in all observed groups (p 0.001). Serious adverse events were not registered during the study.Conclusion. Vaccination with the 13-valent PCV in children with JIA is highly effective and is not accompanied by the development of serious adverse events.

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