THU0563 IMMUNOGENICITY AND SAFETY OF 23-VALENT PNEUMOCOCCAL VACCINE IN PATIENTS WITH ANKYLOSING SPONDYLITIS (PRELIMINARY RESULTS).
Authors: N. Muravyeva, B. Belov, G. Tarasova, M. Cherkasova, G. Lukina
Journal: Annals of the Rheumatic Diseases (2020)

Background: For the treatment of patients with ankylosing spondylitis (AS), biological drugs are widely used, which can effectively control the activity of the disease and radically change the prognosis. However, the use of these drugs is associated with an increasing risk of infections, some of which can probably be prevented by vaccination. Objectives: The aim of the study was to evaluate the immunogenicity and safety of the 23-valent pneumococcal vaccine (PPV-23) in patients with AS. Methods: The study included 18 patients with AS: 14 men, 4 women, age 38.7±11.5 years, duration of the disease 16.2±10.8 years. 5 patients had a history of more than 2 episodes of lower respiratory tract infections (pneumonia, bronchitis). At the time of inclusion in the study in 89% of patients, activity of diseases was assessed as high (median BASDAI was 5.1 [4; 6.2]). All patients received non-steroidal anti-inflammatory drugs, 6 patients - sulfasalazine, 4 - methotrexate, 1 - glucocorticoids, 1 – etanercept. PPV-23 was administered in an amount of 1 dose (0.5 ml) subcutaneously against the background of therapy. In 14 patients vaccination was performed before the appointment of secukinumab; 2 of them continued to take methotrexate, 3 - sulfasalazine. The level of antibodies to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clinical Diagnostics s.r.o., Czech Republic) before vaccination, 1 and 3 months after vaccination. The duration of follow-up was 6.7±4.9 months. Results: The dynamics of the concentration of antibodies to pneumococcal capsular polysaccharide is presented in the table. Table. Concentration of pneumococcal antibodies in patients with AS, U/ml, Me [25; 75 percentile] 1 visit (initial) 2 visit (after 1 month) 3 visit (after 1 month) 78.2 [35.2; 246.3] 246.7 [148.6; 266.1]* 261.1 [214.1; 273,4]** *p=0.04 **p=0.008 After 1 and 3 months after vaccination, the concentration of antibodies to pneumococcal capsular polysaccharide was significantly higher than the baseline values. None of the patients had lower respiratory tract infections. There was no exacerbation of disease. 83% of patients did not have any adverse effects of vaccination. Reactions at the injection site (pain, swelling and hyperemia of the skin up to 2 cm in diameter), resolved independently after 3-5 days, were noted in 2 patients. One patient registered a severe local reaction (infiltration and hyperemia of the skin up to 8 cm in diameter, pain in the arm), accompanied by low-grade fever for 2 days, which required the appointment of antihistamine drugs. Conclusion: Preliminary results indicate satisfactory immunogenicity and safety of the PPV-23 in patients with AS. Further research is needed to better assess the immunogenicity, efficacy and safety of the vaccine. Disclosure of Interests: Natalia Muravyeva: None declared, Boris Belov: None declared, Galina Tarasova: None declared, Maria Cherkasova: None declared, Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche