Measles-specific antibodies loss after a single dose of MMR vaccine in children with oligo-articular JIA on methotrexate treatment: a single-center case-controlled study.

Abstract

Novel treatments have revolutionized the care and outcome of patients with juvenile idiopathic arthritis (JIA). Patients with rheumatic diseases are susceptible to infections, including vaccine preventable ones, due to waning immunity, failing immune system and immunosuppressive treatment received. However, data regarding long-term immunological memory and response to specific vaccines are limited. Assessment of the impact of methotrexate (MTX) treatment on measles-specific-IgG titers, in children with oligo-JIA previously vaccinated with Measles Mumps Rubella (MMR) vaccine (1 dose); by evaluating the persistence of antibodies produced after measles vaccination while on immunomodulating treatment at 0, 12 and 24 months. Single-center controlled study including 54 oligo-JIA patients and 26 healthy controls. Seroprotection rates and measles-specific-IgG titers were measured by ELISA and were expressed as GMCs (Geometric Mean Concentrations).The two groups had similar demographic characteristics, vaccination history and immunization status. Seroprotection rates were adequate for both groups. Nonetheless, measles GMCs were significantly lower in the oligo-JIA compared to the control group at one (p = 0.039) and two years' follow-up (p = 0.021). Children with oligo-JIA on MTX treatment appeared to have lower measles-specific-IgG titers. Further studies are required to assess the long-term immunity conveyed by immunizations given at an early stage in children with rheumatic diseases on synthetic Disease Modifying Antirheumatic Drugs (sDMARDs) and to assess the need for booster doses to subjects at risk.