ANTIGEN-SPECIFIC ANTIBODY-RESPONSES IN LUPUS PATIENTS FOLLOWING IMMUNIZATION

Objective. To determine the safety and efficacy of 3 clinically releva nt vaccines in patients with systemic lupus erythematosus (SLE). Metho ds. We studied 73 consecutive SLE patients immunized with pneumococcal , tetanus toroid (TT), and Haemophilus influenzae type B (HIB) vaccine s. Patients were evaluated preimmunization and 12 weeks postimmunizati on for disease activity and immunization side effects. Results. Eighty -four percent of the SLE patients developed a 4-fold titer increase in response to at least 1 vaccine with 51% developing a 2-fold titer inc rease with all 3 vaccines. The majority of SLE patients developed prot ective levels of antibody to TI (90%) and HIB (88%). Although protecti ve antibody levels could not be determined for pneumococcus, almost ha lf of the patients (47%) developed a 4-fold antibody response. There w as a trend toward a lower antibody response in patients with active di sease treated with immunosuppressive therapy. Overall lupus disease ac tivity was unaffected by immunization. Conclusion. Immunization is saf e in SLE patients,,vith the overwhelming majority developing protectiv e antibody levels. Therefore, SLE patients should receive immunization s according to the recommendations of the Centers for Disease Control and Prevention and the Immunization Practices Advisory Committee.