ArticleClinical rheumatology2026
Evaluation of the efficacy of various hepatitis B dosage regimens in spondyloarthritis patients undergoing immunomodulatory treatment.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess the serologic response to different double-dose hepatitis B vaccination protocols in patients with axial spondyloarthritis receiving biologic therapy. MATERIALS AND
methodsThis single-center, retrospective study included patients diagnosed with axial spondyloarthritis (axSpA) according to ASAS classification criteria. Patients receiving biologic therapy who were non-immune to hepatitis B virus were vaccinated with double-dose hepatitis B vaccine (40 µg) using one of three different vaccination schedules: 0-1-6 months, 0-1-2-12 months, or 0-7-21-365 days. A reference group of axSpA patients treated with nonsteroidal anti-inflammatory drugs and/or conventional DMARDs received the standard-dose hepatitis B vaccine (20 µg) according to the conventional schedule. Anti-hepatitis B surface antibody (anti-HBs) levels were measured one month after completion of vaccination, and an anti-HBs level ≥ 10 IU/L was considered indicative of a protective immune response.
resultsAmong 103 biologic-treated patients with axSpA, 91 patients (88.3%) achieved a protective anti-HBs response following double-dose hepatitis B vaccination, while 12 patients (11.7%) were classified as non-responders. Serologic response rates did not differ significantly among the three double-dose vaccination protocols. In bivariate analyses, non-response was more frequently observed in patients receiving infliximab and certolizumab pegol; however, no independent predictors of non-response were identified in multivariate logistic regression analysis. All patients in the reference group, consisting of biologic-naïve axSpA patients, achieved protective anti-HBs titers following standard-dose hepatitis B vaccination.
conclusionDouble-dose hepatitis B vaccination is associated with high serologic response rates in patients with axial spondyloarthritis receiving biologic therapy, regardless of the vaccination schedule applied. These findings support the use of intensified hepatitis B vaccination strategies in axSpA patients undergoing biologic treatment. Key Points • In biologic-treated axial spondyloarthritis patients, double-dose (40 µg) hepatitis B vaccination achieved a high seroprotection rate of 88.3%. • Similar immune responses across vaccination schedules indicate that antigen dose, rather than timing, is the main determinant of seroprotection.
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