Abstract：
Immunogenicity to meningococcal serogroup ACWY (MenACWY) conjugate vaccine has not been studied in immunocompromised minors with juvenile idiopathic arthritis (JIA) or inflammatory bowel disease (IBD). We determined immunogenicity of a MenACWY-TT vaccine in JIA and IBD patients at adolescent age and compared results to data from aged-matched healthy controls (HCs).
We performed a prospective observational cohort study in JIA and IBD patients (14-18 years old), who received a MenACWY vaccination during a nationwide catch-up campaign (2018-2019) in the Netherlands. Primary aim was to compare MenACWY polysaccharide-specific serum IgG geometric mean concentrations (GMCs) in patients with HCs and secondary between patients with or without anti-TNF therapy. GMCs were determined before and 3-6, 12, and 24 months postvaccination and compared with data from HCs at baseline and 12 months postvaccination. Serum bactericidal antibody (SBA) titers were determined in a subset of patients at 12 months postvaccination.
We included 226 JIA and IBD patients (66 % and 34 % respectively). GMCs were lower for MenA and MenW (GMC ratio 0·24 [0·17-0·34] and 0·16 [0·10-0·26] respectively, p < 0·01) in patients compared to HCs at 12 months postvaccination. Anti-TNF users had lower MenACWY GMCs postvaccination compared with those without anti-TNF (p < 0·01). The proportion protected (SBA ≥ 8) for MenW was reduced in anti-TNF users (76 % versus 92 % in non-anti-TNF and 100 % in HCs, p < 0.01).
The MenACWY conjugate vaccine was immunogenic in the vast majority of JIA and IBD patients at adolescent age, but seroprotection was lower in patients using anti-TNF agents. Therefore, an extra booster MenACWY vaccination should be considered.
We performed a prospective observational cohort study in JIA and IBD patients (14-18 years old), who received a MenACWY vaccination during a nationwide catch-up campaign (2018-2019) in the Netherlands. Primary aim was to compare MenACWY polysaccharide-specific serum IgG geometric mean concentrations (GMCs) in patients with HCs and secondary between patients with or without anti-TNF therapy. GMCs were determined before and 3-6, 12, and 24 months postvaccination and compared with data from HCs at baseline and 12 months postvaccination. Serum bactericidal antibody (SBA) titers were determined in a subset of patients at 12 months postvaccination.
We included 226 JIA and IBD patients (66 % and 34 % respectively). GMCs were lower for MenA and MenW (GMC ratio 0·24 [0·17-0·34] and 0·16 [0·10-0·26] respectively, p < 0·01) in patients compared to HCs at 12 months postvaccination. Anti-TNF users had lower MenACWY GMCs postvaccination compared with those without anti-TNF (p < 0·01). The proportion protected (SBA ≥ 8) for MenW was reduced in anti-TNF users (76 % versus 92 % in non-anti-TNF and 100 % in HCs, p < 0.01).
The MenACWY conjugate vaccine was immunogenic in the vast majority of JIA and IBD patients at adolescent age, but seroprotection was lower in patients using anti-TNF agents. Therefore, an extra booster MenACWY vaccination should be considered.
摘要：
背景：尚未在患有幼年特发性关节炎（JIA）或炎症性肠病（IBD）的免疫受损未成年人中研究脑膜炎球菌血清群ACWY（MenACWY）结合疫苗的免疫原性。我们确定了MenACWY-TT疫苗在青少年JIA和IBD患者中的免疫原性，并将结果与年龄匹配的健康对照（HCs）的数据进行了比较。
方法：我们在JIA和IBD患者（14-18岁）中进行了一项前瞻性观察性队列研究，在荷兰的全国追赶运动（2018-2019）期间接受了MenACWY疫苗接种。主要目的是比较HC患者和有或没有抗TNF治疗的患者之间的MenACWY多糖特异性血清IgG几何平均浓度（GMC）。在接种前和接种后3-6、12和24个月测定GMC，并与基线和接种后12个月的HC数据进行比较。在接种疫苗后12个月时，在一部分患者中确定了血清杀菌抗体（SBA）滴度。
结果：我们纳入了226名JIA和IBD患者（分别为66％和34％）。MenA和MenW的GMC较低（GMC比分别为0·24[0·17-0·34]和0·16[0·10-0·26]，p<0·01）与接种疫苗后12个月的患者相比。与没有使用抗TNF的人相比，抗TNF使用者在接种后的MenACWYGMC较低（p<0.01）。抗TNF使用者中MenW受保护的比例（SBA≥8）降低（76％，非抗TNF为92％，HCs为100％，p<0.01)。
结论：MenACWY结合疫苗对绝大多数青少年JIA和IBD患者具有免疫原性，但使用抗TNF药物的患者血清保护作用较低。因此,应考虑额外加强MenACWY疫苗接种。
方法：我们在JIA和IBD患者（14-18岁）中进行了一项前瞻性观察性队列研究，在荷兰的全国追赶运动（2018-2019）期间接受了MenACWY疫苗接种。主要目的是比较HC患者和有或没有抗TNF治疗的患者之间的MenACWY多糖特异性血清IgG几何平均浓度（GMC）。在接种前和接种后3-6、12和24个月测定GMC，并与基线和接种后12个月的HC数据进行比较。在接种疫苗后12个月时，在一部分患者中确定了血清杀菌抗体（SBA）滴度。
结果：我们纳入了226名JIA和IBD患者（分别为66％和34％）。MenA和MenW的GMC较低（GMC比分别为0·24[0·17-0·34]和0·16[0·10-0·26]，p<0·01）与接种疫苗后12个月的患者相比。与没有使用抗TNF的人相比，抗TNF使用者在接种后的MenACWYGMC较低（p<0.01）。抗TNF使用者中MenW受保护的比例（SBA≥8）降低（76％，非抗TNF为92％，HCs为100％，p<0.01)。
结论：MenACWY结合疫苗对绝大多数青少年JIA和IBD患者具有免疫原性，但使用抗TNF药物的患者血清保护作用较低。因此,应考虑额外加强MenACWY疫苗接种。
