Institute of Rheumatology, Tokyo Women's Medical University , Japan.
Scand J Rheumatol. 2013;42(6):445-50. doi: 10.3109/03009742.2013.788733. Epub 2013 Jun 3.
To investigate the effectiveness of influenza vaccination in patients with rheumatoid arthritis (RA) from a large practice-based cohort.
Patients with RA enrolled in the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort completed self-administered questionnaires as part of the April IORRA surveys of 2001, 2002, 2003, and 2007, which included their influenza vaccination status and occurrence of an actual influenza attack. Vaccine coverage rate and attack rates were calculated in each season. Relative risks (RRs) of vaccination for an actual influenza attack were evaluated and risk factors for influenza infection were determined by multiple logistic regression analysis.
Data from 3529, 4518, 4816, and 4872 patients in the 2000/01, 2001/02, 2002/03, and 2006/07 seasons, respectively, were analysed. Coverage rates were increased from 12.2% in the 2000/01 season to 38.7% in the 2006/07 season. For each season, the attack rates in vaccinated patients trended lower than the rates in unvaccinated patients but the differences were not significant; however, by combining these four seasonal results, the attack rate was significantly lower for vaccinated patients [RR 0.83, 95% confidence interval (CI) 0.71-0.95, p < 0.01]. Male gender [odds ratio (OR) 1.48, 95% CI 1.25-1.76, p < 0.001] was associated with increased risk whereas vaccination was associated with reduced risk for influenza attack (OR 0.76, 95% CI 0.63-0.91, p < 0.01). There were no associations between influenza attacks and RA disease activity, treatment with methotrexate (MTX) or corticosteroids.
Influenza vaccination was effective in patients with RA regardless of disease activity or treatment.
从大型基于实践的队列中研究流感疫苗接种对类风湿关节炎（RA）患者的效果。
参加风湿病学研究所类风湿关节炎（IORRA）队列的 RA 患者完成了作为 2001 年、2002 年、2003 年和 2007 年 4 月 IORRA 调查的一部分的自我管理问卷，其中包括他们的流感疫苗接种状况和实际流感发作情况。在每个季节计算疫苗接种覆盖率和发作率。通过多因素逻辑回归分析评估实际流感发作的疫苗接种相对风险（RR），并确定流感感染的危险因素。
分别分析了 2000/01 季、2001/02 季、2002/03 季和 2006/07 季的 3529、4518、4816 和 4872 名患者的数据。疫苗接种率从 2000/01 季的 12.2%增加到 2006/07 季的 38.7%。对于每个季节，接种疫苗的患者的发病率均低于未接种疫苗的患者，但差异无统计学意义；但是，通过合并这四个季节性结果，接种疫苗的患者的发病率显著降低[RR 0.83，95%置信区间（CI）0.71-0.95，p <0.01]。男性（OR 1.48，95%CI 1.25-1.76，p <0.001）与较高的风险相关，而接种疫苗与流感发作的风险降低相关（OR 0.76，95%CI 0.63-0.91，p <0.01）。流感发作与 RA 疾病活动度或甲氨蝶呤（MTX）或皮质类固醇的治疗之间无关联。
无论疾病活动度或治疗如何，流感疫苗接种对 RA 患者均有效。
