Thomas Konstantinos, Lazarini Argyro, Kaltsonoudis Evripidis, Voulgari Paraskevi V, Drosos Alexandros A, Repa Argyro, Sali Ainour Molla Ismail, Sidiropoulos Prodromos, Tsatsani Panagiota, Gazi Sousana, Fragkiadaki Kalliopi, Tektonidou Maria G, Sfikakis Petros P, Katsimbri Pelagia, Boumpas Dimitrios, Argyriou Evangelia, Boki Kyriaki A, Karagianni Konstantina, Katsiari Christina, Evangelatos Gerasimos, Iliopoulos Alexios, Grika Eleftheria P, Vlachoyiannopoulos Panagiotis G, Dimitroulas Theodoros, Garyfallos Alexandros, Melissaropoulos Konstantinos, Georgiou Panagiotis, Georganas Constantinos, Vounotrypidis Periklis, Ntelis Konstantinos, Areti Maria, Kitas George D, Vassilopoulos Dimitrios
Joint Rheumatology Program, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Rheumatology Clinic, University of Ioannina, Ioannina, Greece.
Front Med (Lausanne). 2023 Jan 9;9:1039464. doi: 10.3389/fmed.2022.1039464. eCollection 2022.
Patients with rheumatoid arthritis (RA) are at increased risk for serious infections. Pneumococcal vaccination is among the most important preventive measures, however, vaccine uptake is suboptimal. We explored the rate and factors associated with pneumococcal vaccination in a contemporary RA cohort.
Multi-center, prospective, RA cohort study in Greece. Patient and disease characteristics and influenza and pneumococcal vaccinations were documented at baseline and 3 years later.
One thousand six hundred and ninety-seven patients were included and 34.5% had already received at least one pneumococcal vaccine at baseline. Among 1,111 non-vaccinated patients, 40.1% received pneumococcal vaccination during follow-up, increasing the vaccine coverage to 60.8%. By multivariate analysis, positive predictors for pneumococcal vaccination included prescription of influenza vaccine (OR = 33.35, 95% CI: 18.58-59.85), history of cancer (OR = 2.35, 95% CI: 1.09-5.06), bDMARD use (OR = 1.85, 95% CI: 1.29-2.65), seropositivity (OR = 1.47, 95% CI: 1.05-2.05), and high disease activity (DAS28-ESR, OR = 1.33, 95% CI: 1.17-1.51). Male sex (OR = 0.65, 95% CI: 0.43-0.99) was a negative predictor for pneumococcal vaccination during follow-up.
Despite increasing rates of pneumococcal vaccine coverage, 40% of RA patients remain unvaccinated. Severe disease, bDMARD use, comorbidities, and more importantly flu vaccination were the most significant factors associated with pneumococcal vaccination, emphasizing the currently unmet need for cultivating a "vaccination culture" in RA patients.
类风湿性关节炎（RA）患者发生严重感染的风险增加。肺炎球菌疫苗接种是最重要的预防措施之一，然而，疫苗接种率并不理想。我们在一个当代RA队列中探讨了肺炎球菌疫苗接种率及其相关因素。
在希腊进行的多中心、前瞻性RA队列研究。在基线和3年后记录患者及疾病特征以及流感和肺炎球菌疫苗接种情况。
纳入1697例患者，34.5%在基线时已接种至少一剂肺炎球菌疫苗。在1111例未接种疫苗的患者中，40.1%在随访期间接种了肺炎球菌疫苗，使疫苗接种率提高到60.8%。多因素分析显示，肺炎球菌疫苗接种的阳性预测因素包括流感疫苗处方（OR = 33.35，95%CI：18.58 - 59.85）、癌症病史（OR = 2.35，95%CI：1.09 - 5.06）、使用生物改善病情抗风湿药（bDMARD）（OR = 1.85，95%CI：1.29 - 2.65）、血清阳性（OR = 1.47，95%CI：1.05 - 2.05）以及疾病活动度高（DAS28 - ESR，OR = 1.33，95%CI：1.17 - 1.51）。男性（OR = 0.65，95%CI：0.43 - 0.99）是随访期间肺炎球菌疫苗接种的阴性预测因素。
尽管肺炎球菌疫苗接种率有所提高，但仍有40%的RA患者未接种疫苗。严重疾病、使用bDMARD、合并症，更重要的是流感疫苗接种是与肺炎球菌疫苗接种相关的最显著因素，强调了目前在RA患者中培养“疫苗接种文化”这一未满足的需求。
