Hepatitis B vaccine less effective in rheumatoid arthritis patients

The results of a study presented today at the European League Against Rheumatism Annual Congress (EULAR 2015) Press Conference showed that people with rheumatoid arthritis (RA) are less likely to be protected by hepatitis B vaccination than the general population. Within the trial only 11% of those with the condition responded to the vaccine, compared with 83% of those without RA, suggesting that people with RA may still be at risk of infection in spite of vaccination.

"The majority of RA patients tested as part of our study were not protected by hepatitis B vaccination," said study investigator MishaTilanus, Radboud University Medical Centre, Nijmegen, Netherlands. "People with RA have an increased risk of morbidity and mortality from infections, and to discover that immunisation might not confer protection is a real concern. It's crucial that patients and healthcare practitioners are aware of this lack of efficacy and do all they can to minimise risk."

RA is a chronic systemic disease that affects the joints, connective tissues, muscle, tendons, and fibrous tissue. The prevalence of RA globally varies between 0.3% and 1% and is more common in women and in developed countries. RA - and many of its treatments - can suppress the immune system, leaving patients at risk of a potentially fatal infection.

Hepatitis B is a life-threatening liver infection caused by the hepatitis B virus. An estimated 240 million people worldwide are chronically infected with hepatitis B, which kills 780,000 people every year.

Vaccination with HBVAXPRO-10 was performed according to the standard regimen (0, 1 and 6 months), with markers of response to the vaccine (hepatitis B antigens, anti-HBsAG) determined after 28 weeks. RA patients had a higher risk for non-response than controls, with an odds ratio of 44 (corrected for age and gender). There was no difference in response between patients using anti-TNF, DMARBs or rituximab.