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Pneumococcal vaccine did not prevent pneumonia in patients with RA
The 23-valent pneumococcal polysaccharide vaccine did not prevent pneumonia in patients with rheumatoid arthritis, according to results from a recently published study.
“Our data showed that [23-valent pneumococcal polysaccharide] PPSV23 vaccination was not effective in preventing pneumonia,” Yasumori Izumi, MD, at the Japanese National Hospital Organization, and colleagues wrote. “While PPSV23 vaccination is recommended for adults [at least] 65 years of age, our results suggested uncertainty regarding its effectiveness for pneumonia in [rheumatoid arthritis] RA patients at high risk for infections.”
Izumi and colleagues performed a double-blinded, randomized trial across rheumatology departments at Japanese National Hospital Organization hospitals. They randomly assigned patients with RA (n = 900) who had been treated with biological or immunosuppressive agents to receive either PPSV23 or placebo. Primary endpoints were rates of all-cause pneumonia and pneumococcal pneumonia, and the secondary endpoint was death. They determined the risk for pneumonia for the vaccinated group compared with placebo.
Researchers found 3.7% of the vaccinated group and 3.4% of the placebo group developed pneumonia; thus, there was no significant difference in the pneumonia rate between groups. For patients with RA, the overall pneumonia rate was 21.8 per 1,000 person-years. In addition, the presence of interstitial pneumonia was associated with increased risk for pneumonia in patients with RA (hazard ratio = 3.6).
“Clinicians should keep in mind the patient’s age and the presence of interstitial pneumonia because such patients are at an increased risk of developing pneumonia,” Izumi and colleagues wrote. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.