Factors Influencing the Efficacy of Two Injections of a Pandemic 2009 Influenza A (H1N1) Nonadjuvanted Vaccine in Systemic Lupus Erythematosus
Identifieur interne : 000734 ( France/Analysis ); précédent : 000733; suivant : 000735Factors Influencing the Efficacy of Two Injections of a Pandemic 2009 Influenza A (H1N1) Nonadjuvanted Vaccine in Systemic Lupus Erythematosus
Auteurs : A. Mathian [France] ; H. Devilliers [France] ; A. Krivine [France] ; N. Costedoat-Chalumeau [France] ; J. Haroche [France] ; D. Boutin-Le Thi Huong [France] ; B. Wechsler [France] ; B. Hervier [France] ; M. Miyara [France] ; N. Morel [France] ; N. Le Corre [France] ; L. Arnaud [France] ; J. C. Piette [France] ; L. Musset [France] ; B. Autran [France] ; F. Rozenberg [France] ; Z. Amoura [France]Source :
- Arthritis and rheumatism [ 0004-3591 ] ; 2011.
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- Pascal (Inist)
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Abstract
Objective. To assess the factors influencing the efficacy of 2 injections of a pandemic 2009 influenza A (H1N1) vaccine in patients with systemic lupus erythematosus (SLE). Methods. We conducted a single-center, observational prospective study of 111 patients who were vaccinated with a monovalent, inactivated, nonadjuvanted, split-virus vaccine during December 2009 and January 2010 and received a second dose of vaccine 3 weeks later. The antibody response was evaluated using the hemagglutination inhibition assay according to the guidelines recommended for the pandemic vaccine, consisting of 3 immunogenicity criteria (i.e., a seroprotection rate of 70%, a seroconversion rate of 40%, and a geometric mean ratio [GMR] of 2.5). Results. The 3 immunogenicity criteria were met on day 42 (seroprotection rate 80.0% [95% confidence interval (95% CI) 72.5-87.5%], seroconversion rate 71.8% [95% CI 63.4-80.2%], and GMR 10.3 [95% CI 2.9-14.2]), while only 2 criteria were met on day 21 (seroprotection rate 66.7% [95% CI 57.9-75.4%], seroconversion rate 60.4% [95% CI 51.3-69.5%], and GMR 8.5 [95% CI 3.2-12.0]). The vaccine was well tolerated. Disease activity, assessed by the Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index, the British Isles Lupus Assessment Group score, and the Systemic Lupus Activity Questionnaire, did not increase. In the multivariate analysis, vaccination failure was significantly associated with immunosuppressive treatment or a lymphocyte count of <1.0 x 109/liter. The second injection significantly increased the immunogenicity in these subgroups, but not high enough to fulfill the seroprotection criterion in patients receiving immunosuppressive treatment. Conclusion. Our findings indicate that the efficacy of the vaccine was impaired in patients who were receiving immunosuppressive drugs or who had lymphopenia. A second injection increased vaccine immunogenicity without reaching all efficacy criteria for a pandemic vaccine in patients receiving an immunosuppressive agent. These results open possibilities for improving anti-influenza vaccination in SLE.
Affiliations:
- France
- Bourgogne, Bourgogne-Franche-Comté, Île-de-France
- Dijon, Paris
- Université Paris-Descartes, Université Pierre-et-Marie-Curie
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Costedoat-Chalumeau</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Haroche, J" sort="Haroche, J" uniqKey="Haroche J" first="J." last="Haroche">J. Haroche</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Boutin Le Thi Huong, D" sort="Boutin Le Thi Huong, D" uniqKey="Boutin Le Thi Huong D" first="D." last="Boutin-Le Thi Huong">D. Boutin-Le Thi Huong</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Wechsler, B" sort="Wechsler, B" uniqKey="Wechsler B" first="B." last="Wechsler">B. Wechsler</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Hervier, B" sort="Hervier, B" uniqKey="Hervier B" first="B." last="Hervier">B. Hervier</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Miyara, M" sort="Miyara, M" uniqKey="Miyara M" first="M." last="Miyara">M. Miyara</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Morel, N" sort="Morel, N" uniqKey="Morel N" first="N." last="Morel">N. Morel</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Le Corre, N" sort="Le Corre, N" uniqKey="Le Corre N" first="N." last="Le Corre">N. Le Corre</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>INSERM UMR-S 945, Groupement Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arnaud, L" sort="Arnaud, L" uniqKey="Arnaud L" first="L." last="Arnaud">L. Arnaud</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J. C." last="Piette">J. C. Piette</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Musset, L" sort="Musset, L" uniqKey="Musset L" first="L." last="Musset">L. Musset</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Autran, B" sort="Autran, B" uniqKey="Autran B" first="B." last="Autran">B. Autran</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Rozenberg, F" sort="Rozenberg, F" uniqKey="Rozenberg F" first="F." last="Rozenberg">F. Rozenberg</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Groupement Hospitalier Cochin, AP-HP, and EA 1833, Université Paris Descartes, Sorbonne Paris Cite</s1><s2>Paris</s2><s3>FRA</s3><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Amoura, Z" sort="Amoura, Z" uniqKey="Amoura Z" first="Z." last="Amoura">Z. Amoura</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0013321</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 12-0013321 INIST</idno><idno type="RBID">Pascal:12-0013321</idno><idno type="wicri:Area/PascalFrancis/Corpus">000852</idno><idno type="wicri:Area/PascalFrancis/Curation">001584</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000B96</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000B96</idno><idno type="wicri:doubleKey">0004-3591:2011:Mathian A:factors:influencing:the</idno><idno type="wicri:Area/Main/Merge">002E50</idno><idno type="wicri:Area/Main/Curation">002D42</idno><idno type="wicri:Area/Main/Exploration">002D42</idno><idno type="wicri:Area/France/Extraction">000734</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Factors Influencing the Efficacy of Two Injections of a Pandemic 2009 Influenza A (H1N1) Nonadjuvanted Vaccine in Systemic Lupus Erythematosus</title><author><name sortKey="Mathian, A" sort="Mathian, A" uniqKey="Mathian A" first="A." last="Mathian">A. Mathian</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Devilliers, H" sort="Devilliers, H" uniqKey="Devilliers H" first="H." last="Devilliers">H. Devilliers</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Centre Hospitalier Universitaire de Dijon</s1><s2>Dijon</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Krivine, A" sort="Krivine, A" uniqKey="Krivine A" first="A." last="Krivine">A. Krivine</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Costedoat Chalumeau, N" sort="Costedoat Chalumeau, N" uniqKey="Costedoat Chalumeau N" first="N." last="Costedoat-Chalumeau">N. Costedoat-Chalumeau</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Haroche, J" sort="Haroche, J" uniqKey="Haroche J" first="J." last="Haroche">J. Haroche</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Boutin Le Thi Huong, D" sort="Boutin Le Thi Huong, D" uniqKey="Boutin Le Thi Huong D" first="D." last="Boutin-Le Thi Huong">D. Boutin-Le Thi Huong</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Wechsler, B" sort="Wechsler, B" uniqKey="Wechsler B" first="B." last="Wechsler">B. Wechsler</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Hervier, B" sort="Hervier, B" uniqKey="Hervier B" first="B." last="Hervier">B. Hervier</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Miyara, M" sort="Miyara, M" uniqKey="Miyara M" first="M." last="Miyara">M. Miyara</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Morel, N" sort="Morel, N" uniqKey="Morel N" first="N." last="Morel">N. Morel</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Le Corre, N" sort="Le Corre, N" uniqKey="Le Corre N" first="N." last="Le Corre">N. Le Corre</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>INSERM UMR-S 945, Groupement Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arnaud, L" sort="Arnaud, L" uniqKey="Arnaud L" first="L." last="Arnaud">L. Arnaud</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J. C." last="Piette">J. C. Piette</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>10 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Musset, L" sort="Musset, L" uniqKey="Musset L" first="L." last="Musset">L. Musset</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Groupement Hospitalier Pitié-Salpêtrière, AP-HP</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Autran, B" sort="Autran, B" uniqKey="Autran B" first="B." last="Autran">B. Autran</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author><author><name sortKey="Rozenberg, F" sort="Rozenberg, F" uniqKey="Rozenberg F" first="F." last="Rozenberg">F. Rozenberg</name><affiliation wicri:level="4"><inist:fA14 i1="06"><s1>Groupement Hospitalier Cochin, AP-HP, and EA 1833, Université Paris Descartes, Sorbonne Paris Cite</s1><s2>Paris</s2><s3>FRA</s3><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Amoura, Z" sort="Amoura, Z" uniqKey="Amoura Z" first="Z." last="Amoura">Z. Amoura</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre de Reference National pour les Lupus et le Syndrome des Antiphospholipides, Groupement Hospitalier Pitié-Salpêtrière, AP-HP, Université Pierre et Marie Curie, Université Paris 06, and INSERM UMR-S 945</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>12 aut.</sZ><sZ>15 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Pierre-et-Marie-Curie</orgName></affiliation></author></analytic><series><title level="j" type="main">Arthritis and rheumatism</title><title level="j" type="abbreviated">Arthritis rheum.</title><idno type="ISSN">0004-3591</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Arthritis and rheumatism</title><title level="j" type="abbreviated">Arthritis rheum.</title><idno type="ISSN">0004-3591</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>H1N1 influenza</term><term>Immunoprophylaxis</term><term>Influenza A</term><term>Prevention</term><term>Rheumatology</term><term>Systemic lupus erythematosus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Grippe A</term><term>Lupus érythémateux disséminé</term><term>Immunoprophylaxie</term><term>Prévention</term><term>Rhumatologie</term><term>Grippe H1N1</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. To assess the factors influencing the efficacy of 2 injections of a pandemic 2009 influenza A (H1N1) vaccine in patients with systemic lupus erythematosus (SLE). Methods. We conducted a single-center, observational prospective study of 111 patients who were vaccinated with a monovalent, inactivated, nonadjuvanted, split-virus vaccine during December 2009 and January 2010 and received a second dose of vaccine 3 weeks later. The antibody response was evaluated using the hemagglutination inhibition assay according to the guidelines recommended for the pandemic vaccine, consisting of 3 immunogenicity criteria (i.e., a seroprotection rate of 70%, a seroconversion rate of 40%, and a geometric mean ratio [GMR] of 2.5). Results. The 3 immunogenicity criteria were met on day 42 (seroprotection rate 80.0% [95% confidence interval (95% CI) 72.5-87.5%], seroconversion rate 71.8% [95% CI 63.4-80.2%], and GMR 10.3 [95% CI 2.9-14.2]), while only 2 criteria were met on day 21 (seroprotection rate 66.7% [95% CI 57.9-75.4%], seroconversion rate 60.4% [95% CI 51.3-69.5%], and GMR 8.5 [95% CI 3.2-12.0]). The vaccine was well tolerated. Disease activity, assessed by the Safety of Estrogens in Lupus Erythematosus National Assessment version of the SLE Disease Activity Index, the British Isles Lupus Assessment Group score, and the Systemic Lupus Activity Questionnaire, did not increase. In the multivariate analysis, vaccination failure was significantly associated with immunosuppressive treatment or a lymphocyte count of <1.0 x 10<sup>9</sup>/liter. The second injection significantly increased the immunogenicity in these subgroups, but not high enough to fulfill the seroprotection criterion in patients receiving immunosuppressive treatment. Conclusion. Our findings indicate that the efficacy of the vaccine was impaired in patients who were receiving immunosuppressive drugs or who had lymphopenia. A second injection increased vaccine immunogenicity without reaching all efficacy criteria for a pandemic vaccine in patients receiving an immunosuppressive agent. These results open possibilities for improving anti-influenza vaccination in SLE.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Bourgogne</li><li>Bourgogne-Franche-Comté</li><li>Île-de-France</li></region><settlement><li>Dijon</li><li>Paris</li></settlement><orgName><li>Université Paris-Descartes</li><li>Université Pierre-et-Marie-Curie</li></orgName></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Mathian, A" sort="Mathian, A" uniqKey="Mathian A" first="A." last="Mathian">A. Mathian</name></region><name sortKey="Amoura, Z" sort="Amoura, Z" uniqKey="Amoura Z" first="Z." last="Amoura">Z. Amoura</name><name sortKey="Arnaud, L" sort="Arnaud, L" uniqKey="Arnaud L" first="L." last="Arnaud">L. Arnaud</name><name sortKey="Autran, B" sort="Autran, B" uniqKey="Autran B" first="B." last="Autran">B. Autran</name><name sortKey="Boutin Le Thi Huong, D" sort="Boutin Le Thi Huong, D" uniqKey="Boutin Le Thi Huong D" first="D." last="Boutin-Le Thi Huong">D. Boutin-Le Thi Huong</name><name sortKey="Costedoat Chalumeau, N" sort="Costedoat Chalumeau, N" uniqKey="Costedoat Chalumeau N" first="N." last="Costedoat-Chalumeau">N. Costedoat-Chalumeau</name><name sortKey="Devilliers, H" sort="Devilliers, H" uniqKey="Devilliers H" first="H." last="Devilliers">H. Devilliers</name><name sortKey="Devilliers, H" sort="Devilliers, H" uniqKey="Devilliers H" first="H." last="Devilliers">H. Devilliers</name><name sortKey="Haroche, J" sort="Haroche, J" uniqKey="Haroche J" first="J." last="Haroche">J. Haroche</name><name sortKey="Hervier, B" sort="Hervier, B" uniqKey="Hervier B" first="B." last="Hervier">B. Hervier</name><name sortKey="Krivine, A" sort="Krivine, A" uniqKey="Krivine A" first="A." last="Krivine">A. Krivine</name><name sortKey="Le Corre, N" sort="Le Corre, N" uniqKey="Le Corre N" first="N." last="Le Corre">N. Le Corre</name><name sortKey="Miyara, M" sort="Miyara, M" uniqKey="Miyara M" first="M." last="Miyara">M. Miyara</name><name sortKey="Morel, N" sort="Morel, N" uniqKey="Morel N" first="N." last="Morel">N. Morel</name><name sortKey="Musset, L" sort="Musset, L" uniqKey="Musset L" first="L." last="Musset">L. Musset</name><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J. C." last="Piette">J. C. Piette</name><name sortKey="Rozenberg, F" sort="Rozenberg, F" uniqKey="Rozenberg F" first="F." last="Rozenberg">F. Rozenberg</name><name sortKey="Wechsler, B" sort="Wechsler, B" uniqKey="Wechsler B" first="B." last="Wechsler">B. Wechsler</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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