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Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis.

Abstract

OBJECTIVE

To determine the clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis (RA).

METHODS

The present study was conducted by using the Taiwan National Health Insurance Research Database. In this retrospective nationwide study, we included 3748 RA patients who received influenza vaccinations in 2008, 2009 and 2010, and 3748 matched RA patients who did not receive influenza vaccinations. We followed the patients from 4 weeks after influenza vaccination to the end of the influenza season in each year. After adjustment for potential confounding factors, including disease-modifying anti-rheumatic drugs, we used the Cox proportional hazards regression model to analyze the clinical effectiveness of influenza vaccination.

RESULTS

The influenza vaccination rate in RA patients was 14.8% in 2008, 19.8% in 2009 and 9.50% in 2010. Receiving influenza vaccine was associated with reduced risk of hospitalization for septicemia, bacteremia or viremia (hazards ratio [HR] = 0.65, 95% CI = 0.45-0.94), and lower risk of mortality (HR = 0.62, 95% CI = 0.39-0.97). The effectiveness was particularly significant in elderly patients.

CONCLUSIONS

RA patients receiving influenza vaccine have significantly lower morbidity and mortality, particularly in elderly patients. Further studies are needed to explore effective policies to increase the vaccination rate in elderly RA patients.

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  • Authors+Show Affiliations

    ,

    Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan.

    ,

    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. College of Medicine, China Medical University, Taichung, Taiwan.

    ,

    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. College of Medicine, China Medical University, Taichung, Taiwan.

    ,

    Healthcare Service Research Center, Taichung Veterans General Hospital, Taichung, Taiwan.

    ,

    Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan. Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.

    Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan. Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan. Department of Nursing, Min-Hwei College of Health Care Management, Tainan City, Taiwan.

    Source

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Antirheumatic Agents
    Arthritis, Rheumatoid
    Chi-Square Distribution
    Databases, Factual
    Female
    Humans
    Influenza Vaccines
    Influenza, Human
    Male
    Middle Aged
    Proportional Hazards Models
    Retrospective Studies
    Risk Factors
    Taiwan
    Time Factors
    Treatment Outcome
    Vaccination
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29879317

    Citation

    Chen, Chun-Ming, et al. "Clinical Effectiveness of Influenza Vaccination in Patients With Rheumatoid Arthritis." International Journal of Rheumatic Diseases, vol. 21, no. 6, 2018, pp. 1246-1253.
    Chen CM, Chen HJ, Chen WS, et al. Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis. Int J Rheum Dis. 2018;21(6):1246-1253.
    Chen, C. M., Chen, H. J., Chen, W. S., Lin, C. C., Hsu, C. C., & Hsu, Y. H. (2018). Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis. International Journal of Rheumatic Diseases, 21(6), pp. 1246-1253. doi:10.1111/1756-185X.13322.
    Chen CM, et al. Clinical Effectiveness of Influenza Vaccination in Patients With Rheumatoid Arthritis. Int J Rheum Dis. 2018;21(6):1246-1253. PubMed PMID: 29879317.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis. AU - Chen,Chun-Ming, AU - Chen,Hsuan-Ju, AU - Chen,Wei-Shan, AU - Lin,Che-Chen, AU - Hsu,Chih-Cheng, AU - Hsu,Yueh-Han, PY - 2018/6/8/entrez PY - 2018/6/8/pubmed PY - 2018/10/16/medline KW - autoimmune disease KW - disease-modifying anti-rheumatic drugs KW - effectiveness KW - influenza vaccination KW - rheumatoid arthritis SP - 1246 EP - 1253 JF - International journal of rheumatic diseases JO - Int J Rheum Dis VL - 21 IS - 6 N2 - OBJECTIVE: To determine the clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis (RA). METHODS: The present study was conducted by using the Taiwan National Health Insurance Research Database. In this retrospective nationwide study, we included 3748 RA patients who received influenza vaccinations in 2008, 2009 and 2010, and 3748 matched RA patients who did not receive influenza vaccinations. We followed the patients from 4 weeks after influenza vaccination to the end of the influenza season in each year. After adjustment for potential confounding factors, including disease-modifying anti-rheumatic drugs, we used the Cox proportional hazards regression model to analyze the clinical effectiveness of influenza vaccination. RESULTS: The influenza vaccination rate in RA patients was 14.8% in 2008, 19.8% in 2009 and 9.50% in 2010. Receiving influenza vaccine was associated with reduced risk of hospitalization for septicemia, bacteremia or viremia (hazards ratio [HR] = 0.65, 95% CI = 0.45-0.94), and lower risk of mortality (HR = 0.62, 95% CI = 0.39-0.97). The effectiveness was particularly significant in elderly patients. CONCLUSIONS: RA patients receiving influenza vaccine have significantly lower morbidity and mortality, particularly in elderly patients. Further studies are needed to explore effective policies to increase the vaccination rate in elderly RA patients. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/29879317/Clinical_effectiveness_of_influenza_vaccination_in_patients_with_rheumatoid_arthritis_ L2 - https://doi.org/10.1111/1756-185X.13322 DB - PRIME DP - Unbound Medicine ER -