Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept

Alten, Rieke; Bingham, Clifton O.; Cohen, Stanley B.; Curtis, Jeffrey R.; Kelly, Sheila; Wong, Dennis; Genovese, Mark C.

doi:10.1186/s12891-016-1082-z

Table 4 Relationship of baseline factors with pneumococcal and influenza immunologic responses

From: Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept

Baseline characteristic		Pneumococcal vaccine		Influenza vaccine
Baseline characteristic		n/N (%)	OR (95 % CI)	n/N (%)	OR (95 % CI)
Patients without protective antibody levels at baseline^a
MTX dose at baseline, mg/week	None	2/4 (50.0)	0.3 (0.0, 3.0)	1/3 (33.3)	0.4 (0.0, 4.5)
	>0–10	5/7 (71.4)	0.6 (0.1, 6.0)	17/25 (68.0)	1.6 (0.5, 4.7)
	>10–15	19/25 (76.0)	0.8 (0.1, 4.8)	35/36 (62.5)	1.3 (0.5, 3.0)
	>15	8/10 (80.0)	0.8 (0.1, 4.8)	20/35 (57.1)	1.3 (0.5, 3.0)
Steroid at baseline	Yes	19/26 (73.1)	0.9 (0.2, 3.4)	47/74 (63.5)	1.3 (0.6, 2.7)
Steroid at baseline	No	15/20 (75.0)	0.9 (0.2, 3.4)	26/45 (57.8)	1.3 (0.6, 2.7)
Age at main study baseline, years	<55	28/35 (80.0)	3.3 (0.8, 14.2)	60/88 (68.2)	3.0 (1.3, 6.9)
Age at main study baseline, years	≥55	6/11 (54.5)	3.3 (0.8, 14.2)	13/31 (41.9)	3.0 (1.3, 6.9)
Patients with protective antibody levels at baseline^a
MTX dose at baseline, mg/week	None	2/6 (33.3)	0.6 (0.1, 4.1)	3/5 (60.0)	3.6 (0.5, 26.8)
	>0–10	8/15 (53.3)	1.4 (0.4, 5.4)	3/12 (25.0)	0.8 (0.2, 3.9)
	>10–15	9/25 (36.0)	0.7 (0.2, 2.3)	5/24 (20.8)	0.6 (0.2, 2.4)
	>15	9/20 (45.0)	0.7 (0.2, 2.3)	7/24 (29.2)	0.6 (0.2, 2.4)
Steroid at baseline	Yes	16/37 (43.2)	1.1 (0.4, 2.9)	10/40 (25.0)	0.7 (0.2, 2.1)
Steroid at baseline	No	12/29 (41.4)	1.1 (0.4, 2.9)	8/25 (32.0)	0.7 (0.2, 2.1)
Age at main study baseline, years	<55	23/47 (48.9)	2.7 (0.8, 8.6)	16/52 (30.8)	2.4 (0.5, 12.3)
Age at main study baseline, years	≥55	5/19 (26.3)	2.7 (0.8, 8.6)	2/13 (15.4)	2.4 (0.5, 12.3)
Total population^b
Protective antibody level at baseline	Yes	28/66 (42.4) *	0.3 (0.1, 0.6)	18/65 (27.7) **	0.2 (0.1, 0.5)
Protective antibody level at baseline	No	34/46 (73.9) *	0.3 (0.1, 0.6)	73/119 (61.3) **	0.2 (0.1, 0.5)
MTX dose at baseline, mg/week	None	4/10 (40.0)	0.5 (0.1, 2.2)	4/8 (50.0)	1.2 (0.3, 5.2)
	>0–10	13/22 (59.1)	1.1 (0.4, 3.4)	20/37 (54.1)	1.4 (0.6, 3.2)
	>10–15	28/50 (56.0)	1.0 (0.4, 2.4)	40/80 (50.0)	1.2 (0.6, 2.3)
	>15	17/30 (56.7)	1.0 (0.4, 2.4)	27/59 (45.8)	1.2 (0.6, 2.3)
Steroid at baseline	Yes	35/63 (55.6)	1.0 (0.5, 2.2)	57/114 (50.0)	1.1 (0.6, 1.9)
Steroid at baseline	No	27/49 (55.1)	1.0 (0.5, 2.2)	34/70 (48.6)	1.1 (0.6, 1.9)
Age at main study baseline, years	<55	51/82 (62.2)	2.8 (1.2, 6.8) ***	76/140 (54.3)	2.3 (1.1, 4.7) ***
Age at main study baseline, years	≥55	11/30 (36.7)	2.8 (1.2, 6.8) ***	15/44 (34.1)	2.3 (1.1, 4.7) ***

Based on the total population, regardless of protective antibody status at baseline. ORs and 95 % likelihood ratio CIs are based on a logistic regression model: vaccine response = baseline factor. ORs and CIs are presented for each category versus the reference category (baseline protective [no], MTX >15 mg/week, steroid [no], age ≥55 years). P-values are for confounding factors. Patients with >42 days between the pre- and post-vaccination sample dates were excluded from the analysis
CI confidence interval, MTX methotrexate, OR odds ratio
^aMultivariate model; ^bbivariate model; *p = 0.0013; **p < 0.0001; ***p < 0.05

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