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Immune response to pneumococcal polysaccharide vaccine in adults with chronic plaque psoriasis treated with alefacept - 14/09/11

Doi : 10.1016/j.jaad.2010.04.040 
Charles Lynde, MD a, , James Krell, MD b, Neil Korman, MD, PhD c, Barbara Mathes, MD d

Vaccine Study Investigators

a Lynde Center for Dermatology, Markham, Ontario, Canada 
b Total Skin and Beauty Dermatology Center, Birmingham, Alabama 
c University Hospitals of Cleveland, Cleveland, Ohio 
d University of Pennsylvania, Philadelphia, Pennsylvania 

Reprint requests: Charles Lynde, MD, Lynde Center for Dermatology, 5762 Hwy 7 E, Suite 201, Markham, ON L3P 1A8, Canada.

Abstract

Background

Alefacept is a T cell–modulating biologic therapy for psoriasis that could affect patients' ability to mount immune responses.

Objective

This open-label, phase IV, multicenter study assessed the ability of adults with chronic plaque psoriasis receiving alefacept to generate antibodies to a pneumococcal polysaccharide vaccine (PPV).

Methods

Patients were treated with a standard 12-week course of alefacept and administered the 23-valent PPV at week 6. Antipneumococcal antibodies were measured at baseline and weeks 6, 9, 12, and 33. The primary end point was the percentage of patients with a 2-fold or greater increase from prevaccination (week 6) to 6 weeks postvaccination (week 12) in antibody titers to 2 or more of 5 designated PPV antigens.

Results

Of 43 patients enrolled, 42 were included in the full analysis set, with 86% of patients exhibiting a 2-fold or greater increase and 57% of patients exhibiting a 4-fold or greater increase in antibody titers to 2 or more of 5 designated antigens from prevaccination to 6 weeks postvaccination. At 6 months postvaccination, 78% of patients had a 2-fold or greater increase and 47% of patients had a 4-fold or greater increase in antibody titers to 2 or more of the 5 designated antigens. There were statistically significant increases in mean antibody titers to all 23 antigens in PPV from prevaccination to 6 weeks postvaccination.

Limitations

This was an open-label study with no comparator.

Conclusions

Most patients mounted immune responses to PPV; increases in antibody titers in these patients were consistent with those seen in healthy individuals.

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Key words : alefacept, biologics, pneumococcal polysaccharide vaccine, psoriasis, T cells, vaccines

Abbreviations used : AE, CI, IL, PPV, PSO, TNF


Mappa


 The study and publication development were funded by Astellas Pharma Global Development Inc.
 Disclosure: Dr Lynde has served as a consultant, researcher, and speaker for EMD Serono Inc, Astellas, Genentech, Amgen/Wyeth, Centocor, Ortho Biotech, Schering Canada, Leo Pharma, Abbott, Isotechnika, and Celgene. Dr Krell has served as a consultant, investigator, and speaker for and received funding for research from Biogen Idec and Astellas Pharma US; has served as consultant, investigator, and speaker for Genentech; was an investigator and speaker for Abbott Pharmaceuticals and Amgen; and was a speaker for Centocor. Dr Korman has served as a consultant, on advisory boards, and as a speaker for Abbott, Amgen, Astellas, Centocor, Genentech, and Novartis; was an investigator and received research funding from Abbott, Amgen, Astellas, Centocor, Genentech, and Novartis; and received fellowship funding from Centocor. Dr Mathes is a consultant for Astellas Pharma Global Development Inc, was formerly an employee of Biogen Idec, and is involved in clinical trials with alefacept.


© 2010  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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