THU0296 Influenza and Pneumococcal Vaccination in Patients on Biotherapies. A Report on 594 Patients from Four Hospitals
Authors: O. Brocq, F. Berthier, C. Albert-Sabonnadiere, G. Bolla, E. Millasseau, C. Destombe, J. Azulay, C. Asquier, E. Acquacalda, A. Florent, S. Le Seaux, L. Euller-Ziegler
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> To evaluate pneumococcal (PV) and influenza (IV) vaccination status in patients (pts) on biotherapies by researching influencing factors. <h3>Methods</h3> Pts on biotherapies seen between February and July 2013 were questioned about PV and IV status. Variables analysed: age, sex, disease, treatment, immunisation status, reason for non-vaccination and history of pulmonary infection on biotherapy. Percentage comparisons were performed using chi-square and McNemar9s tests. <h3>Results</h3> 594 pts were analysed (406 F + 188 M): 307 rheumatoid arthritis (RA) (51 M +256 F, mean age 59 years); 277 spondyloarthritis (SpA) (135 M +142 F, mean age 48 years); and 10 other diseases. In the RA group, 189 pts were treated with anti-TNFs: 115 with etanercept (Etn); 37 with adalimumab (Ada); 19 with infliximab (Inf); 13 with certolizumab (Cer); and 5 with golimumab (Gol). 118 other pts were treated with another biotherapy, including 42 with rituximab (Rtx); 38 with tocilizumab (To); 24 with abatacept (Aba); and 14 with anakinra (Ana);151 pts had at least 2 biotherapies. One DMARD was combined in 60% and cortisone in 35%. In the SpA group, 271 were treated with anti-TNFs (Ada 121, Etn 85, Inf 46, Gol 14, Cer 5) and 6 with other biotherapies, 86 pts had at least 2 biotherapies. One DMARD was combined in 28% and cortisone in 5%. The 2012-2013 winter IV (recommended for 37% by the general practitioner [GP]; 45% for RA and 28% for SpA), and in 63% after age 65, and in 79% by the rheumatologist (including 82% for RA and 75% for SpA, and in 93% after age 65) was given to 260 pts (43.77%; including 44% for RA and 43% for SpA and in 62% of pts &gt;65 years). Pts having refused were 47%, (55% were RA and 39% were SpA), generally because of fear (45% RA and 32% SpA). PV over the last 5 years (recommended in 14% by the GP, including 16% for RA and 12% for SpA, and in 24% after age 65, and in 78% by the rheumatologist in RA and SpA, and in 86% after age 65) had been done for 370 pts (62.29%; including 60% in RA and 65% in SpA, and in 70% over age 65). Pts having refused were 25% (31% RA and 17% SpA). In total, 37% had two vaccinations (53% after age 65): 33% one of two; 30% neither of the two. 67 pts (48 RA) had an infection (11%), including 20 hospitalisations. Variables selected for a better vaccination: a prior IV; the recommendation by the GP and the rheumatologist (p&lt;0.001); age &gt;65 years (IV p&lt;0.001, PV p=0.02). The other parameters were not influencing (type and number of biotherapies, DMARDs, cortisone, disease). Infections were not lower in those vaccinated compared to those non-vaccinated (number of pts too low). The PV was up-to-date more frequently than the IV (p&lt;0.001) in the two diseases. Fear of side effects was one of the causes of non-vaccination. <h3>Conclusions</h3> The rate of IV was 44% compared to 62% for PV. Age influences the vaccination status, as well as the information given to the patient. This should be repeated with pts and physicians in order to improve protection. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1935