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Rheumatology (Oxford). 2009 Feb;48(2):144-8. doi: 10.1093/rheumatology/ken436. Epub 2008 Dec 11.

Efficacy of measles, mumps and rubella revaccination in children with juvenile idiopathic arthritis treated with methotrexate and etanercept.

Author information

1
Department of Clinical Immunology and Transfusion Medicine, University of Leipzig, Johannisallee 30, D-04103 Leipzig, Germany. stephan.borte@medizin.uni-leipzig.de

Abstract

OBJECTIVES:

To evaluate the influence of low-dose MTX and etanercept treatment on efficacy of measles, mumps and rubella (MMR) revaccination in children with juvenile idiopathic arthritis.

METHODS:

A prospective nested case-control study was performed to investigate markers of MMR revaccination induced humoral and cell-mediated immunity in 15 patients with juvenile idiopathic arthritis (ages 6-17 yrs), treated with either low-dose MTX therapy alone or in combination with etanercept. The control group consisted of 22 healthy children. Production of IFN-gamma by T memory cells upon in vitro stimulation with measles, mumps and rubella antigens and seroprevalence of virus-specific IgG antibodies were assessed. Medication use, disease activity and patients' comments on side-effects were observed during the period of 6 months before and after revaccination.

RESULTS:

Low-dose MTX therapy following MMR vaccination proved not to hamper T-cell mediated immunity in vitro. Neither low-dose MTX nor etanercept treatment, given simultaneously with revaccination, markedly interfered with generation of long-lived virus-restricted T cells and protective levels of virus-specific IgG antibodies. No increase in disease activity or medication use was seen within 6 months after MMR revaccination, including JIA patients using etanercept. No overt measles, mumps, rubella or secondary severe infections were noted.

CONCLUSIONS:

Low-dose MTX and etanercept treatment do not seem to interfere with intended outcome of MMR revaccination in children with JIA.

PMID:
19074187
DOI:
10.1093/rheumatology/ken436
[Indexed for MEDLINE]

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