Heijstek Marloes W, Pileggi Gecilmara C S, Zonneveld-Huijssoon Evelien, Armbrust Wineke, Hoppenreijs Esther P A H, Uiterwaal Cuno S P M, Kuis Wietse, Wulffraat Nico M
Department of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Room KC 03-0630, PO Box 85090, 3508 AB Utrecht, The Netherlands.
Ann Rheum Dis. 2007 Oct;66(10):1384-7. doi: 10.1136/ard.2006.063586. Epub 2007 Feb 6.
To assess the effect of measles, mumps and rubella (MMR) vaccination on disease activity in children with juvenile idiopathic arthritis (JIA).
A retrospective observational multicentre cohort study was performed in 314 patients with JIA, born between 1989 and 1996. Disease activity and medication use were compared during the period of 6 months before vaccination versus 6 months after vaccination. Disease activity was measured by joint counts, the Physician's global assessment scale and erythrocyte sedimentation rate. Next, we compared disease activity in patients vaccinated between 8 and 9 years of age with the activity in patients who had not been vaccinated at this time (who received MMR between the ages of 9 and 10 years).
No increase in disease activity or medication use was seen in the 6 months after MMR vaccination (n = 207), including in patients using methotrexate (n = 49). No overt measles infections were noted. When disease activity in vaccinated patients (n = 108) was compared with activity in those not yet vaccinated (n = 86), there were no significant differences.
The MMR booster vaccination does not seem to aggravate disease activity in JIA. This indicates that the most patients with JIA can be vaccinated safely with the MMR vaccine. A prospective study is recommended.
评估麻疹、腮腺炎和风疹（MMR）疫苗接种对幼年特发性关节炎（JIA）患儿疾病活动的影响。
对1989年至1996年出生的314例JIA患者进行了一项回顾性观察多中心队列研究。比较疫苗接种前6个月与接种后6个月期间的疾病活动情况和药物使用情况。疾病活动通过关节计数、医生整体评估量表和红细胞沉降率来衡量。接下来，我们比较了8至9岁接种疫苗的患者与此时未接种疫苗（9至10岁接种MMR）的患者的疾病活动情况。
MMR疫苗接种后6个月（n = 207），包括使用甲氨蝶呤的患者（n = 49），疾病活动或药物使用均未见增加。未观察到明显的麻疹感染。将接种疫苗患者（n = 108）的疾病活动与未接种疫苗患者（n = 86）的疾病活动进行比较时，未发现显著差异。
MMR加强疫苗接种似乎不会加重JIA的疾病活动。这表明大多数JIA患者可以安全接种MMR疫苗。建议进行前瞻性研究。
