INTRODUCTION Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood. The therapy with tumor necrosis factor (TNF) inhibitors (TNFi) in JIA patients has demonstrated efficacy and safety. The most reported adverse event is the high susceptibility to infections. Preventive vaccination helps to decrease these risks. The information on response to vaccines in JIA patients having treatment with anti-TNF is limited. OBJECTIVES To evaluate the response to pneumococcal vaccine in JIA patients undergoing treatment with mAb. MATERIALS AND METHODS Analytical observational mixed cohort study. Data obtained from the clinical records of an immunorheumatology polyclinic of a metropolitan hospital in Santiago (Chile). Treatments, pneumococcal vaccine schedules, immunological laboratory, and measurement of specific antibodies against 10 pneumococcal serotypes were recorded. RESULTS Nineteen patients were included; average age was 13.8 years; and average evolution time of the disease was 46.2 months. Adalimumab (Humira®) was indicated in case of 13 patients (68.4%) and etanercept (Enbrel®) to 6 (31.5%). The most indicated scheme was a dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed at 8 weeks by a dose of pneumococcal polysaccharide vaccine (PPSV23) in nine (47.3%) patients. Seventeen (89.4%) patients were on immunosuppressive treatment at the time of vaccination. Only one patient did not meet the criteria for response to vaccine. CONCLUSIONS The pneumococcal vaccine induces protective levels of serum antibodies in JIA patients undergoing TNFi treatment. The vaccination schedule and the lymphocyte count could influence the response capacity.

中文翻译：

---

用肿瘤坏死因子抑制剂治疗特发性幼年关节炎患者的肺炎球菌疫苗。

简介 幼年特发性关节炎 (JIA) 是儿童期最常见的风湿病。在 JIA 患者中使用肿瘤坏死因子 (TNF) 抑制剂 (TNFi) 治疗已证明有效和安全。报告最多的不良事件是对感染的高度易感性。预防性疫苗接种有助于降低这些风险。关于接受抗 TNF 治疗的 JIA 患者对疫苗的反应的信息是有限的。目的 评估接受 mAb 治疗的 JIA 患者对肺炎球菌疫苗的反应。材料和方法 分析观察混合队列研究。从圣地亚哥（智利）一家大都会医院免疫风湿病综合诊所的临床记录中获得的数据。治疗，肺炎球菌疫苗时间表，免疫实验室，并记录了针对 10 种肺炎球菌血清型的特异性抗体的测量。结果 纳入 19 名患者；平均年龄为 13.8 岁；平均发病时间为46.2个月。阿达木单抗（Humira®）适用于 13 名患者（68.4%）和依那西普（Enbrel®）至 6 名（31.5%）。最受关注的方案是在 8 周后对 9 名 (47.3%) 患者接种一剂肺炎球菌多糖疫苗 (PPSV23)，然后接种一剂 13 价肺炎球菌结合疫苗 (PCV13)。17 名 (89.4%) 患者在接种疫苗时正在接受免疫抑制治疗。只有一名患者不符合对疫苗反应的标准。结论 肺炎球菌疫苗在接受 TNFi 治疗的 JIA 患者中诱导血清抗体的保护水平。