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The Real-World Study of Immunogenicity and Safety of the Adjuvant Recombinant Vaccine against Varicella Zoster Virus in Patients with Immune-Mediated Inflammatory Diseases Treated with Janus Kinase Inhibitors
oleh: Ana Esteban-Vazquez, Martina Steiner, Elisabet Castañeda, Cristina Andreu-Vazquez, Israel J. Thiussard, Angela Somodevilla, Moisés Gracia-Martínez, Rosa Sánchez-Diaz, Cristina García-Yubero, Maria Beatriz Paredes-Romero, Santiago Munoz-Fernández
| Format: | Article |
|---|---|
| Diterbitkan: | MDPI AG 2023-10-01 |
Deskripsi
<b>Background</b>. The risk of herpes zoster reactivation is increased in immunocompromised patients, especially in those with immune-mediated inflammatory diseases (IMIDs) on Janus kinase inhibitor (JAKi) treatment. The recombinant subunit herpes zoster vaccine (RZV) is a non-live vaccine, recently approved for this subgroup of patients, which shows high rates of vaccine effectiveness, with few adverse effects reported in clinical trials. <b>Purpose</b>. The aim of this real-world study was to determine the immunogenicity and safety of RZV in IMID patients on JAKi treatment. <b>Methods</b>. The increase in the concentration of anti-gE antibody for varicella zoster virus post-vaccination, compared to the pre-vaccination concentration, was analyzed to test the humoral immune response. Adverse effects after the first and second vaccine doses were registered. <b>Results</b>. In total, 49 patients were analyzed, and a fourfold increase in antibody concentration was achieved in almost 40% of subjects, with only one serious local adverse effect. <b>Discussion</b>. The resulting immunogenicity was lower than that observed in clinical trials, probably due to the presence of immune disease and immunosuppressive treatment, and to the fact that this was a real-world study. No differences in response according to age, previous virus zoster reactivation, or concomitant treatments were found. <b>Conclusions</b>. RZV was well tolerated and reached the immune response objective in 40% of patients. These results reinforce the importance of including RZV vaccination for immunosuppressed patients. Real-world studies regarding vaccine effectiveness are still needed in order to gain a full understanding of the response to RZV in this group of patients.