Evidence map›Paper›PMID 37640516›Full record

ArticleRMD open2023

Maternal and neonatal antibody levels on pertussis vaccination in pregnant women on immune-modulating therapy for rheumatic disease.

Nafise Ghalandari, Maarten M Immink, Esther Röder, Patricia C J Bruijning-Verhagen, Hieronymus Smeele, Hubertina Crijns, Nicoline A T van der Maas, Mireille N Bekker, Elisabeth A M Sanders, Radboud J E M Dolhain

Open access · goldAbstract read
In one paragraph

Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 18% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Observational
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Nafise GhalandariDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands nafise.ghalandari@gmail.com.ORCID 0000-0002-7130-2749
Maarten M ImminkCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Esther RöderDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.ORCID 0000-0003-2139-3838
Patricia C J Bruijning-VerhagenCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Hieronymus SmeeleDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.ORCID 0000-0001-7724-7712
Hubertina CrijnsMedicines Evaluation Board, Utrecht, Netherlands.
Nicoline A T van der MaasCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Mireille N BekkerDepartment of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Elisabeth A M SandersCenter for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
Radboud J E M DolhainDepartment of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.
Erasmus MC · NLUniversity Medical Center Utrecht · NLMedicines Evaluation Board · NLNational Institute for Public Health and the Environment · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWhile protection against pertussis following maternal tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccination was demonstrated in healthy term-born infants, no evidence is available on Tdap vaccination in combination with immune-modulating therapy during pregnancy. In this pilot study, we explored whether treatment with tumour necrosis factor alpha inhibitors (TNFis) in pregnant patients with rheumatic disease interferes with Tdap vaccine responses and affects maternal anti-pertussis IgG antibody levels in newborns.

methodsPatients were included by a rheumatologist during pregnancy in case they received maternal Tdap vaccination in the late-second or early-third trimester of pregnancy. Blood samples were obtained from mothers during the first pregnancy trimester, 3 months after delivery and from the umbilical cord. IgG antibody levels against Tdap-included antigens were measured using a bead-based multiplex immunoassay. Findings on patients exposed to TNFis were compared with those from TNFi-unexposed patients and with data from a historical comparator study among healthy Tdap vaccinated mother-infant pairs (n=53).

results66 patients (46 exposed and 20 unexposed to TNFIs) were enrolled. No major differences in IgG antibody levels were observed between TNFi-exposed and unexposed mothers before maternal Tdap vaccination and 3 months after delivery. In cord sera, however, antibody levels against pertussis toxin were significantly lower after TNFi-treatment (35.94 IU/mL, 95% CI 20.68 to 62.45) compared with no TNFi-treatment of mothers with rheumatic disease (94.61 IU/mL, 95% CI 48.89 to 183.07) and lower compared with a cohort of healthy mothers (125.12 IU/mL, 95% CI 90.75 to 172.50). We observed similar differences for filamentous haemagglutinin, pertactin, tetanus toxoid and diphtheria toxoid.

conclusionThese preliminary data indicate no major differences in IgG antibody levels on maternal Tdap vaccination in pregnant women with or without immune-modulating treatment, although our findings suggest that TNFis during pregnancy induce lower maternal anti-pertussis-specific protective antibody levels in newborns.

Indexed as

Pregnant PeopleRheumatic DiseasesFemaleHealth StatusHumansInfantInfant, NewbornPilot ProjectsPregnancyVaccinationArthritis, RheumatoidBiological TherapyTumor Necrosis Factor InhibitorsVaccination

Identifiers

PMID37640516
PMCPMC10462940
OpenAlexW4386227223

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.