Table 7.
Efficacy, immunogenicity and safety of 23-valent pneumococcal polysaccharide vaccine (PPSV23) in patients with AIIRD (October 2009–August 2018)
| First author +ref. | Year | Study design | No. cases | No. ST |
Efficacy | Immunogenicity | Safety | LoE | ||
| Eff. | Imm. | Saf. | ||||||||
| Izumi120 | 2017 | RCT | 464 RA–vaccinated 436 RA–placebo |
NA | Similar efficacy in vaccinated versus placebo | – | No safety issue | 1b-2b | – | – |
| Kivitz76 | 2014 | RCT | 110 RA-Certolizumab (68%+MTX) 114 RA-Placebo (68%+MTX) |
6 | – | No difference between certolizumab and placebo | – | – | 1b-2b | – |
| Hesselstrand131 | 2018 | Cohort | 44 SSc:
49 HC |
2 | – | Lower response in patients treated with DMARDs | No safety issue | – | 2b | 4 |
| Jaeger53 | 2017 | Cohort | 16 patients with CAPS | NA | – | – | Significant side effects | – | 4 | – |
| Chatham125 | 2017 | Cohort | 34 SLE PPSV23 4 weeks before, and 45 SLE 24 weeks after belimumab |
23 | – | Adequate response, not affected by belimumab | No safety issue | – | 2b | 4 |
| Broyde130 | 2016 | Cohort (retrospective) | 88 RA and SpA vaccinated 42 RA and SpA non-vaccinated |
NA | – | Preserved immunogenicity after 7 years | – | – | 2b | – |
| Winthrop84 Part A |
2016 | Cohort | 102 RA-Tofacitinib 98 RA-Placebo |
12 | – | Reduced response in tofacitinib-treated patients | – | – | 2b | – |
| Winthrop84 Part B |
2016 | Cohort | 92 RA-Cont Tofacitinib 91 RA-Stop Tofacitinib |
12 | – | No difference between groups | – | – | 2b | – |
| Alten83 | 2016 | Cohort | 125 RA ABA+MTX | 5 | – | Adequate response | No safety issue | 2b | 4 | |
| Rezende116 | 2016 | Cohort | 54 SLE | 7 | – | Poor immunogenicity | – | 2b | – | |
| Migita109 | 2015 | Cohort | 35 RA-DMARDs 55 RA-MTX 21 RA-ABA +MTX |
2 | – | Reduced response in abatacept-treated patients | No safety issue | 2b | 4 | |
| Migita124 | 2015 | Cohort | 35 RA-DMARDs 55 RA-MTX 24 RA-Golimumab +MTX |
2 | – | Reduced response in golimumab-treated patients | No safety issue | 2b | 4 | |
| Migita119 | 2015 | Cohort | 35 RA-DMARDs 55 RA-MTX 29 RA-Tacrolimus 14 RA-Tacrolimus +MTX |
2 | – | Higher response in tacrolimus-treated patients | No safety issue | 2b | 4 | |
| Bingham112 | 2015 | Cohort | 27 RA-MTX 54 RA-MTX +TCZ |
12 | – | Similar response in patients treated with MTX or MTX +TCZ | No safety issue | 2b | 4 | |
| Fischer115 | 2015 | Cohort | 57 vaccinated/122 non-vaccinated RA, SpA, vasc., CTD | NR | – | Adequate response | – | 4 | – | |
| Tsuru81 | 2014 | Cohort | 21 RA-TCZ | 12 | – | All TCZ-treated patients responded | – | 2b | – | |
| Mori113 | 2013 | Cohort | 62 RA-MTX 54 RA-MTX+TCZ 50 RA-TCZ 24 RA-DMARDs |
2 | – | Better response in patients treated with TCZ | No safety issue | 2b | 4 | |
| Coulson121 | 2011 | Cohort (retrospective) | 124 RA vaccinated 28 RA non-vaccinated |
NA | Reduced rate of pneumonia in vaccinated | Preserved immunogenicity after 7 years | – | 4 | 2b | |
| Rehnberg107 | 2010 | Cohort | 11 RA-RTX 36 weeks 8 RA-Pre-RTX 1 week 10 RA-DC |
NR | – | Reduced in patients treated with RTX | – | 4 | – | |
ABA, abatacept; CAPS, cryopyrin-associated periodic syndrome; cont., continued; CTD, connective tissue disease; DC, disease control; DMARD, disease-modifying antirheumatic drug; eff., efficacy; HC, healthy controls; imm., immunogenicity; LoE, level of evidence; MTX, methotrexate; No., number; NR, not reported; PCV, pneumococcal conjugate vaccine; PPSV, pneumococcal polysaccharide vaccine; RA, rheumatoid arthritis; RCT, randomised controlled trial; Ref., reference; RTX, rituximab; saf., safety; SLE, systemic lupus erythematosus; SpA, spondyloarthropathy; SSc, systemic sclerosis; ST, serotypes; TCZ, tocilizumab; vasc., vasculitis.