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Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study.
Rheumatology (Oxford). 2017 09 01; 56(9):1484-1491.R

Abstract

Objectives

Pneumococcal, tetanus and influenza vaccinations are recommended for patients with cryopyrin-associated periodic syndromes (CAPS) when treated with immunosuppressive medication. The aim of this publication is to report the safety of pneumococcal and other vaccinations in CAPS patients.

Methods

All CAPS patients followed in the β-CONFIDENT (Clinical Outcomes and Safety Registry study of Ilaris patients) registry were analysed if they had received a vaccination. The β-CONFIDENT registry is a global, long-term, prospective, observational registry, capturing and monitoring patients treated with canakinumab.

Results

Sixty-eight CAPS patients had received a total of 159 vaccine injections, 107 injections against influenza, 19 pneumococcal vaccinations, 12 against tetanus/diphtheria antigens and 21 other vaccinations. Fourteen per cent of injections had elicited at least one vaccine reaction. All five vaccine-related serious adverse events were associated with pneumococcal vaccination. Vaccine reactions were observed in 70% of pneumococcal vaccinations, compared with 7% in influenza and 17% in tetanus/diphtheria vaccinations. The odds ratios to react to the pneumococcal vaccines compared with influenza and tetanus/diphtheria vaccines were 31.0 (95% CI: 8, 119) and 10.8 (95% CI: 2, 74). Vaccine reactions after pneumococcal vaccinations were more severe and lasted significantly longer (up to 3 weeks) compared with other vaccinations. In two patients, pneumococcal vaccination also elicited symptoms consistent with systemic inflammation due to CAPS reactivation.

Conclusion

Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic inflammation in CAPS patients. Clinicians must balance potential benefits of pneumococcal immunization against safety concerns. The 13-valent pneumococcal conjugate vaccine might be favourable over the polysaccharide vaccine in CAPS patients.

Authors+Show Affiliations

Department of Rheumatology, University Hospital Basel, Basel, Switzerland.Department of Medicine, University of California. Division of Allergy and Immunology, Rady Children's Hospital, San Diego, CA, USA.Division of Infectious Diseases & Center of Experimental and Molecular Medicine Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.Novartis Pharma AG, Basel, Switzerland.Novartis Pharma AG, Basel, Switzerland.Novartis Pharma AG, Basel, Switzerland.QuintilesIMS, Real World Insights, Research Triangle Park, NC, USA.Novartis Pharma AG, Basel, Switzerland.National Amyloidosis Centre, University College London, London, UK.Division of Pediatric Rheumatology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany.Department of Rheumatology, University Hospital Basel, Basel, Switzerland.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

28482054

Citation

Jaeger, Veronika K., et al. "Safety of Vaccinations in Patients With Cryopyrin-associated Periodic Syndromes: a Prospective Registry Based Study." Rheumatology (Oxford, England), vol. 56, no. 9, 2017, pp. 1484-1491.
Jaeger VK, Hoffman HM, van der Poll T, et al. Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study. Rheumatology (Oxford). 2017;56(9):1484-1491.
Jaeger, V. K., Hoffman, H. M., van der Poll, T., Tilson, H., Seibert, J., Speziale, A., Junge, G., Franke, K., Vritzali, E., Hawkins, P. N., Kuemmerle-Deschner, J., & Walker, U. A. (2017). Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study. Rheumatology (Oxford, England), 56(9), 1484-1491. https://doi.org/10.1093/rheumatology/kex185
Jaeger VK, et al. Safety of Vaccinations in Patients With Cryopyrin-associated Periodic Syndromes: a Prospective Registry Based Study. Rheumatology (Oxford). 2017 09 1;56(9):1484-1491. PubMed PMID: 28482054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study. AU - Jaeger,Veronika K, AU - Hoffman,Hal M, AU - van der Poll,Tom, AU - Tilson,Hugh, AU - Seibert,Julia, AU - Speziale,Antonio, AU - Junge,Guido, AU - Franke,Kristina, AU - Vritzali,Eleni, AU - Hawkins,Philip N, AU - Kuemmerle-Deschner,Jasmin, AU - Walker,Ulrich A, PY - 2016/11/21/received PY - 2017/5/10/pubmed PY - 2017/9/28/medline PY - 2017/5/9/entrez KW - CAPS KW - cryopyrin-associated periodic syndromes KW - safety KW - vaccinations SP - 1484 EP - 1491 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 56 IS - 9 N2 - Objectives: Pneumococcal, tetanus and influenza vaccinations are recommended for patients with cryopyrin-associated periodic syndromes (CAPS) when treated with immunosuppressive medication. The aim of this publication is to report the safety of pneumococcal and other vaccinations in CAPS patients. Methods: All CAPS patients followed in the β-CONFIDENT (Clinical Outcomes and Safety Registry study of Ilaris patients) registry were analysed if they had received a vaccination. The β-CONFIDENT registry is a global, long-term, prospective, observational registry, capturing and monitoring patients treated with canakinumab. Results: Sixty-eight CAPS patients had received a total of 159 vaccine injections, 107 injections against influenza, 19 pneumococcal vaccinations, 12 against tetanus/diphtheria antigens and 21 other vaccinations. Fourteen per cent of injections had elicited at least one vaccine reaction. All five vaccine-related serious adverse events were associated with pneumococcal vaccination. Vaccine reactions were observed in 70% of pneumococcal vaccinations, compared with 7% in influenza and 17% in tetanus/diphtheria vaccinations. The odds ratios to react to the pneumococcal vaccines compared with influenza and tetanus/diphtheria vaccines were 31.0 (95% CI: 8, 119) and 10.8 (95% CI: 2, 74). Vaccine reactions after pneumococcal vaccinations were more severe and lasted significantly longer (up to 3 weeks) compared with other vaccinations. In two patients, pneumococcal vaccination also elicited symptoms consistent with systemic inflammation due to CAPS reactivation. Conclusion: Pneumococcal vaccines, unlike other vaccines, frequently trigger severe local and systemic inflammation in CAPS patients. Clinicians must balance potential benefits of pneumococcal immunization against safety concerns. The 13-valent pneumococcal conjugate vaccine might be favourable over the polysaccharide vaccine in CAPS patients. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/28482054/Safety_of_vaccinations_in_patients_with_cryopyrin_associated_periodic_syndromes:_a_prospective_registry_based_study_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kex185 DB - PRIME DP - Unbound Medicine ER -