ArticleClinical and experimental immunology2014
Rituximab impairs immunoglobulin (Ig)M and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients.
Article in Clinical and experimental immunology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 7 of them syntheses that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 7 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Brazilian Society of Rheumatology - 2025 recommendations on vaccination in immune-mediated rheumatic diseases.Advances in rheumatology (London, England) · 2026Guideline
- 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases.Arthritis & rheumatology (Hoboken, N.J.) · 2023Guideline
- 2022 American College of Rheumatology Guideline for Vaccinations in Patients With Rheumatic and Musculoskeletal Diseases.Arthritis care & research · 2023Guideline
- Immunogenicity of COVID-19 vaccines in patients with diverse health conditions: A comprehensive systematic review.Journal of medical virology · 2022Pooled it
- Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2022Pooled it
- American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 3.Arthritis & rheumatology (Hoboken, N.J.) · 2021Guideline
- American College of Rheumatology Guidance for COVID-19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 1.Arthritis & rheumatology (Hoboken, N.J.) · 2021Guideline
- Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis: The VELOCE study.Neurology · 2020Trial
- Pharmacokinetics, pharmacodynamics, and tolerability of single ascending doses of RCT-18 in Chinese patients with rheumatoid arthritis.Clinical pharmacokinetics · 2014Trial
- Vaccination in systemic lupus erythematosus.Human vaccines & immunotherapeutics · 2026Review
- Human primary antibody response to vaccination follows a partially sequential class-switching program with a checkpoint at IGHG2.Cell reports. Medicine · 2026Article
- Vaccination Update and Specific Concerns for RA.Current rheumatology reports · 2025Review
- First Report of the Immunogenicity of an Inactivated SARS-CoV-2 (COVID-19) Vaccine in Iranian Patients with Autoimmune Diseases.European journal of rheumatology · 2025Article
- New-onset systemic vasculitis following SARS-CoV-2 infection and vaccination: the trigger, phenotype, and outcome.Clinical rheumatology · 2023Review
- T follicular helper cell responses to SARS-CoV-2 vaccination among healthy and immunocompromised adults.Immunology and cell biology · 2023Review
- Selective suppression of de novo SARS-CoV-2 vaccine antibody responses in patients with cancer on B cell-targeted therapy.JCI insight · 2023Article
- Rituximab is associated with worse COVID-19 outcomes in patients with rheumatoid arthritis: A retrospective, nationally sampled cohort study from the U.S. National COVID Cohort Collaborative (N3C).Seminars in arthritis and rheumatism · 2023Article
- Vaccination Rates, Perceptions, and Information Sources Used by People With Inflammatory Arthritis.ACR open rheumatology · 2023Article
- Immunogenicity of inactivated COVID-19 vaccine in patients with autoimmune inflammatory rheumatic diseases.Scientific reports · 2022Article
- Efficacy of inactivated vaccines in patients treated with immunosuppressive drug therapy.Pharmacotherapy · 2022Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rituximab (RTX) treatment in rheumatoid arthritis (RA) patients severely hampers humoral response after influenza vaccination as determined by haemagglutination inhibition assay (HI). It is not known whether HI reflects both immunoglobulin (Ig)M and IgG (subclass) influenza response, and whether IgM antibodies contribute to the low rate of influenza infection seen in RA patients. Twenty RA patients on methotrexate (MTX), 23 on RTX and 28 healthy controls (HC) received trivalent influenza subunit vaccination. Before and 28 days after vaccination, H1N1- and H3N2-specific antibodies were measured by HI and by IgM and IgG (subclass) enzyme-linked immunosorbent assay (ELISA). B cell activating factor (BAFF) levels were determined in serum samples before vaccination. Vaccination induced a significant increase of IgM and IgG (IgG1 and IgG3) antibodies against both strains in the HC and MTX groups (all P < 0·01), but not in the RTX group. HI correlated significantly in all cases with IgG (IgG1) but not with IgM. In RTX late patients (RTX treatment 6-10 months before vaccination), IgG (IgG1 and IgG3) response to vaccination was restored, but not IgM response. BAFF levels were significantly increased in RA-RTX patients and correlated with total IgG levels. Haemagglutination inhibition assay, used as gold standard, detects primarily IgG (IgG1) responses. IgM- and IgG influenza-specific antibodies increase after vaccination in HC and RA patients except in patients on RTX treatment. BAFF levels are increased in both early and late RTX-treated patients, but do not correlate with an influenza-specific antibody response.
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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.