Differences in persistence of measles, mumps, rubella, diphtheria and tetanus antibodies between children with rheumatic disease and healthy controls: a retrospective cross-sectional study

• Published in: Annals of the rheumatic diseases Vol. 71; no. 6; pp. 948 - 954
• Main Authors: Heijstek, Marloes W, van Gageldonk, Pieter GM, Berbers, Guy AM, Wulffraat, Nico M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.06.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adolescent; Age; Antibodies, Viral - blood; Antibodies, Viral - immunology; Arthritis; Arthritis, Juvenile - drug therapy; Arthritis, Juvenile - epidemiology; Arthritis, Juvenile - immunology; Biological and medical sciences; Child; Child, Preschool; Children; Corticoids; Cross-Sectional Studies; Diphtheria; Diphtheria - prevention & control; Diphtheria-Tetanus-Pertussis Vaccine - immunology; Disease; Diseases; Diseases of the osteoarticular system; Enzyme-linked immunosorbent assay; Evaluation; Female; Glucocorticoids - therapeutic use; Health; Health care; Human viral diseases; Humans; Immunization; Immunoassays; Immunoglobulin G; Immunoglobulins; Immunology; Immunosuppressive Agents - therapeutic use; Infant; Infections; Infectious diseases; Male; Measles; Measles - prevention & control; Measles-Mumps-Rubella Vaccine - immunology; Measurement; Medical sciences; Methotrexate; Methotrexate - therapeutic use; Miscellaneous. Osteoarticular involvement in other diseases; Mumps; Mumps - prevention & control; Netherlands - epidemiology; Patients; Pediatrics; Public health; Retrospective Studies; Rheumatic diseases; Rheumatology; Rubella; Rubella - prevention & control; Seroepidemiologic Studies; Statistical analysis; Studies; Tetanus; Tetanus - prevention & control; Toxoids; Vaccines; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Young Adult; Youth; Netherlands; Human; Rubella; Antibody; Diseases of the osteoarticular system; Rheumatology; Diphtheria; Infection; Persistence; Viral disease; Cross sectional study; Measles; Bacteriosis; Rheumatism; Mumps; Tetanus; Child
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2011-200637

Objectives To compare the persistence of measles, mumps, rubella, diphtheria and tetanus antibodies between patients with juvenile idiopathic arthritis (JIA) and healthy controls. Methods Measles, mumps, rubella (MMR) and diphtheria–tetanus toxoid (DT)-specific immunoglobulin G antibody concentrations were compared between 400 patients with JIA and 2176 healthy controls aged 1–19 years. Stored patient samples from the period 1997–2006 were obtained from one Dutch centre for paediatric rheumatology. Healthy control samples had been evaluated previously in a nationwide cohort. Participants had been vaccinated according to the Dutch immunisation programme. Antibody concentrations were measured by ELISA (MMR) or multiplex immunoassay (DT). Results Corrected for age and the number of vaccinations, lower vaccine-specific geometric mean antibody concentrations (GMC) were found in patients with JIA against mumps, rubella, diphtheria and tetanus (p≤0.001). Measles-specific GMC were higher (p<0.001) compared with healthy controls. The prevalence of protective antibody concentrations was significantly lower in patients for mumps (OR 0.4; 95% CI 0.3 to 0.6), rubella (OR 0.4; 0.3 to 0.7), diphtheria (OR 0.1; 0.06 to 0.2) and tetanus (OR 0.1; 0.05 to 0.3). Seroprotection rates against measles did not differ between patients and healthy controls (OR 1.4; 0.8 to 2.5). Methotrexate and glucocorticosteroid use did not affect pathogen-specific GMC or seroprotection rates. Conclusions Patients with JIA had lower antibody concentrations and seroprotection rates than healthy controls against mumps, rubella, diphtheria and tetanus, but not measles. In these patients, regular assessment of antibody concentrations and further research on responses to other (booster) vaccines are warranted.