Evidence map›Paper›PMID 41330694›Full record

Trial reportRheumatology (Oxford, England)2026

Impaired cellular immune responses to herpes zoster subunit vaccine in patients with rheumatoid arthritis receiving Janus kinase inhibitors.

Hanna Källmark, Birgitta Gullstrand, Fredrik Kahn, Elsa Grenmyr, Robin Kahn, Jon T Einarsson, Anders A Bengtsson, Meliha C Kapetanovic

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Rheumatology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03886038 (The Immunogenicity and Efficacy of Subunit Vaccine Against Herpes Zoster in RA Treated With JAK-inhibitors), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT03886038 phase4completednot on this map

The Immunogenicity and Efficacy of Subunit Vaccine Against Herpes Zoster in RA Treated With JAK-inhibitors (VACCIMIL-ZOSTER)

TypeinterventionalSponsorRegion SkaneRan2019 to 2022Enrolled142ConditionsRheumatoid Arthritis, Healthy ControlsArmsShingrix
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

8 authors.

Hanna KällmarkDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.ORCID 0000-0003-3092-5074
Birgitta GullstrandDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Fredrik KahnDepartment of Clinical Sciences, Section of Infection Medicine, Lund University, Lund, Sweden.ORCID 0000-0001-5566-6350
Elsa GrenmyrDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Robin KahnDepartment of Rheumatology, Skåne University Hospital, Lund and Malmö, Sweden.ORCID 0000-0002-3167-1179
Jon T EinarssonDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Anders A BengtssonDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
Meliha C KapetanovicDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.ORCID 0000-0002-7853-514X

Funding

Anna-Greta Crafoords Stiftelse för Reumatologisk Forskning
6 · The paper itself

Abstract

objectiveTo investigate cellular immune responses to the herpes zoster (HZ) subunit (HZ/su) vaccine in patients with rheumatoid arthritis (RA) treated with Janus kinase inhibitors (JAKis).

methodsRA patients treated with JAKi (n = 46) at the Department of Rheumatology, Skåne University Hospital, Sweden, and healthy controls (n = 37) received two doses of the HZ/su vaccine. Blood samples were collected before and ∼6 weeks after vaccination. Varicella zoster virus (VZV) glycoprotein E (gE)-specific lymphocyte proliferation was analysed using flow cytometry. gE-specific production of tumour necrosis factor (TNF)α and IFNγ was analysed using an immunoassay. gE-specific responses were compared before and after vaccination within the groups (Wilcoxon signed-rank test), and between the patients and the controls (Mann-Whitney, ANCOVA). Proportions achieving a positive vaccine response were compared between the groups (Chi2 test).

resultsFollowing vaccination, gE-specific proliferation of CD19+ cells increased significantly in both the patients (P = 0.016) and the controls (P < 0.001). For patients, no statistically significant differences were seen after vaccination for gE-specific proliferation of CD4+ or CD8+ cells or production of TNFα or IFNγ. Lower proportions of patients than the controls achieved a positive vaccine response for gE-specific proliferation of CD4+, CD8+ and CD19+ cells and gE-specific TNFα.

conclusionThe lack of significant increases in both vaccine-specific proliferation of CD4+ and CD8+ cells and proinflammatory cytokines after vaccination indicate impaired T cell responses to the HZ/su vaccination in patients with RA treated with JAKi. These results suggest that to ensure satisfactory cellular immunity in patients with RA, vaccination against HZ should preferably be performed before the initiation of JAKi treatment. CLINICAL

trial registrationClinicalTrials.gov; NCT03886038.

Indexed as

Arthritis, RheumatoidHerpes ZosterHerpes Zoster VaccineImmunity, CellularJanus Kinase InhibitorsAdultAgedCase-Control StudiesFemaleHumansMaleMiddle AgedTumor Necrosis Factor-alphaVaccines, SubunitHerpes Zoster VaccineJanus Kinase InhibitorsTumor Necrosis Factor-alphaVaccines, Subunitherpes zosterJanus kinase inhibitorsRAvaccinationvaccine immunogenicity

Identifiers

PMID41330694
PMCPMC12861083

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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.