Evidence map›Paper›PMID 23851398›Full record

Trial reportBlood2013

The effect of rituximab on vaccine responses in patients with immune thrombocytopenia.

Ishac Nazi, John G Kelton, Mark Larché, Denis P Snider, Nancy M Heddle, Mark A Crowther, Richard J Cook, Alan T Tinmouth, Joy Mangel, Donald M Arnold

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Blood, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03069703 (Multicenter Randomized Controlled Trial Comparing Immunogenicity and Safety of Two Innovative Anti-pneumococcal Vaccine Strategies to Standard Vaccination Regimen in Patients With ANCA-associated Vasculitis Receiving Rituximab Therapy), which is not on this map. Cited by 97 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 9 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03069703 phase2completednot on this mapstarted 2018, after this paper: background citation

Multicenter Randomized Controlled Trial Comparing Immunogenicity and Safety of Two Innovative Anti-pneumococcal Vaccine Strategies to Standard Vaccination Regimen in Patients With ANCA-associated Vasculitis Receiving Rituximab Therapy

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2018 to 2021Enrolled96ConditionsInvasive Pneumococcal InfectionArmsPCV13, PPV23, Rituximab
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 9 syntheses or guidelines pooled it, 186 citations in OpenAlex.

  1. Guideline
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  10. Trial
  11. Article
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  16. Observational
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Ishac NaziDepartment of Medicine and.
John G Kelton
Mark Larché
Denis P Snider
Nancy M Heddle
Mark A Crowther
Richard J Cook
Alan T Tinmouth
Joy Mangel
Donald M Arnold
Canadian Blood Services · CAMcMaster University · CAUniversity of Waterloo · CAWestern University · CA

Funding

CIHR 89897CIHR 89897-1
6 · The paper itself

Abstract

B-cell depletion may impair vaccine responses and increase infection risk in patients with immune thrombocytopenia (ITP). We investigated the effects of rituximab on antibody and cellular responses to Streptococcus pneumoniae polysaccharide and Haemophilus influenzae type b (Hib) vaccines in ITP patients. Of 60 patients in the main trial, 24 patients received both vaccines 6 months after rituximab (n = 17) or placebo (n = 7). Among 20 evaluable patients, 3 of 14 (21%) in the rituximab group and 4 of 6 (67%) in the placebo group achieved a fourfold increase in anti-pneumococcal antibodies (P = .12). For anti-Hib antibodies, 4 of 14 (29%) and 5 of 6 (83%), respectively, achieved a fourfold increase (P < .05). Fewer patients in the rituximab group demonstrated Hib killing (2 of 14 [14%], 5 of 6 [83%], P < .05). Three of 14 rituximab-treated patients failed to respond to vaccines by any criteria. After vaccinations, preplasma cell blasts and interferon-γ-secreting T cells were reduced in rituximab-treated patients. Antibody responses were impaired for at least 6 months after rituximab. Cellular immunity was reduced in parallel with depleted B-cell pools. These findings have implications for the timing of vaccinations and the mechanism of infection after rituximab in ITP patients.

Indexed as

AdultAgedAntibodies, BacterialAntibodies, Monoclonal, Murine-DerivedBacterial CapsulesB-Lymphocyte SubsetsCombined Modality TherapyDouble-Blind MethodDrug Therapy, CombinationFemaleHaemophilus influenzae type bHaemophilus VaccinesHumansImmunity, CellularInterferon-gammaMaleAntibodies, BacterialAntibodies, Monoclonal, Murine-DerivedHaemophilus influenzae type b polysaccharide vaccineHaemophilus VaccinesInterferon-gammaRituximab

Identifiers

PMID23851398
PMCPMC3773242
OpenAlexW2011342000

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.