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Burden of Disease

Burden of Disease

Description of the DiseaseGlobal EpidemiologyIndian EpidemiologyPneumococcal Disease and InfluenzaChallenges

Risk Factors
 

Risk Factors

Secondary Infections
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Secondary Infections

Mechanism of Action
​​​​​​​

Mechanism of Action

Prevention of Pneumococcal Disease
 

Polysaccharide VaccineConjugate VaccineDifference

Need for Pneumococcal Vaccination

In ElderlyIn India

Cost-effectiveness of PCV13
 

NeedIndian StudiesGlobal Studies

Legacy of Prevenar
 

ManufacturingCRM197Activation and ConjugationPneumococcal Disease and InfluenzaDistributionVideos

Safety
 

Safety

Conclusion
 

Conclusion
Dosing

Dosing
 

Adults ≥18 Years of AgeAdults ≥50 Years of AgeCOVID VaccinationFlu Vaccination
Efficacy

Prevenar 13® Clinical Experience
 

IntroductionClinical Trials

Efficacy of Prevenar 13®
 

IntroductionStudyObjectiveMethodologyCriteriaResultsConclusion

Effectiveness of Prevenar 13® 
 

IntroductionObjectiveMethodologyAnalysisResultsLimitationsLearningsConclusion

Indian Clinical Trials
 

IntroductionStudy DesignResultsLimitationsConclusion
Recommendations for Use

Recommendations for Use
 

ACIP 2019NCCN 2020RSSDI 2020IMA GuidelinesIAOH Guidelines for Working AdultsClinical Practice Guidelines 2019 (ICS/NCCP)The Geriatric Society of India, 2015Indian Society of Nephrology
FAQs

PCV13 in Pulmonology
 

RoleComplicationsClinical DataRecommendations

PCV13 in Nephrology
 

RoleClinical DataRecommendations

PCV13 in Oncology
 

RoleClinical DataRecommendations

PCV13 in Rheumatology
 

RoleComplicationsDataRecommendationsConsensus

PCV13 in Diabetes
 

RoleComplicationsDataRecommendations

PCV13 in HIV Infection
 

RoleBurdenPulmonary InfectionDataEfficacyRecommendations

PCV13 in Cardiology
 

RoleBurdenComplicationsDataRecommendations
Resources

Resources

Summary of Prescribing InformationDownloadable ResourcesEvents and WebinarsLatest Articles

Data

Immunogenicity Data of Pneumococcal Vaccines in Patients With Rheumatologic Diseases

   

There is paucity of data regarding the effectiveness of pneumococcal vaccinations in patients with AIRD who are undergoing immunosuppressive therapy.1 In a prospective, multicentre, double-blind, randomised, placebo-controlled trial, the effectiveness of PPSV23 in 900 patients with RA was evaluated across different Japanese hospitals. No difference in the rates of pneumonia were observed between the 2 study groups, which indicated that PPSV23 does not prevent against pneumonia overall in patients with RA.2 A study compared the immunogenicity response of PCV13 in patients with RA with or without DMARDs. The study reported that the immunogenicity of PCV13 is not impaired in patients with RA who are not treated with a DMARD, and recommended that PCV13 should be used in patients with RA before the initiation of a DMARD.3 A long-term extension trial substudy revealed that around two-third of patients with RA on long-term baricitinib treatment achieved satisfactory immune response to PCV13, and that in patients taking concomitant corticosteroids, the response to PCV13 was not diminished.4 Another study found that vaccination with PCV13 was well tolerated and effective in patients with RA who were treated with etanercept.5

   

A recent study evaluated the antibody response of a prime boost strategy (single doses of PCV13 and PPSV23), as compared with a single PCV13 in patients with inflammatory rheumatic diseases. The patient either received treatment with different immunosuppressive drugs or controls. The study revealed that as compared with single pneumococcal vaccine, prime boost vaccination is more immunogenic in patients treated with DMARD or abatacept, but not in patients treated with rituximab. Therefore, pneumococcal vaccination should be encouraged prior to rituximab therapy initiation.6

   

A cross-sectional study assessed the vaccination coverage for PCV13 and PPSV23 in rheumatology patients on biological treatment. The vaccination coverage for PPSV23 was 77.9% and 80.2% for PCV13. The study concluded that pneumococcal vaccination had high coverage in these patients, and referring such patients to correct the immunisation would also help minimise a few of the infectious adverse effects of biological therapies.7

   

The impact of systemic sclerosis, a chronic inflammatory rheumatic disease, and DMARD treatment on the antibody response elicited by PCV13 or PPSV23, was evaluated in a study. The findings revealed that both PCV13 and PPSV23 yielded satisfactory antibody response in those patients who were not receiving DMARD treatment. However, a lower antibody response was elicited in patients with systemic sclerosis who were treated with synthetic DMARDs.8 Other rheumatic diseases include SLE, which is a systemic, autoimmune disease with heterogeneous clinical manifestations. A study explored the impact of SLE and belimumab given in addition to standard of care therapy, on the immunogenic response of these patients towards PCV13. The antibody response to PCV13 was not impaired even in those patients with SLE who were given belimumab in addition to a traditional DMARD.9

   

   

AIRD, autoimmune rheumatic disease; DMARD, disease-modifying antirheumatic drug; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal plain polysaccharide vaccine; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus.

   

​​​​​​​References:

Rákóczi É, Szekanecz Z. Pneumococcal vaccination in autoimmune rheumatic diseases. RMD Open. 2017;3(2):e000484.Izumi Y, Akazawa M, Akeda Y, et al. The 23-valent pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis: a double blinded, randomized, placebo-controlled trial. Arthritis Res Ther. 2017;19(1):15.Nived P, Saxne T, Geborek P, Mandl T, Skattum L, Kapetanovic MC. Antibody response to 13-valent pneumococcal conjugate vaccine is not impaired in patients with rheumatoid arthritis or primary Sjögren’s syndrome without disease modifying treatment. BMC Rheumatol. 2018;2:12.Winthrop KL, Bingham CO 3rd, Komocsar WJ, et al. Evaluation of pneumococcal and tetanus vaccine responses in patients with rheumatoid arthritis receiving baricitinib: results from a long-term extension trial substudy. Arthritis Res Ther. 2019;21(1):102.Rákóczi É, Perge B, Végh E, et al. Evaluation of the immunogenicity of the 13-valent conjugated pneumococcal vaccine in rheumatoid arthritis patients treated with etanercept. Joint Bone Spine. 2016;83(6):675-679.Nived P, Jönsson G, Settergren B, et al. Prime-boost vaccination strategy enhances immunogenicity compared to single pneumococcal conjugate vaccination in patients receiving conventional DMARDs, to some extent in abatacept but not in rituximab-treated patients. Arthritis Res Ther. 2020;22(1):36.Fernández-Prada M, Brandy-García AM, Rodríguez-Fonseca OD, Huerta-González I, Fernández-Noval F, Martínez-Ortega C. Evaluation of pneumococcal and influenza vaccination coverage in rheumatology patients receiving biological therapy in a regional referral hospital. Reumatol Clin. 2020;16(2 Pt 1):97-102.Hesselstrand R, Nagel J, Saxne T, Geborek P, Skattum L, Kapetanovic MC. Immunogenicity and safety of pneumococcal vaccination in patients with systemic sclerosis. Rheumatology (Oxford). 2018;57(4):625-630.Nagel J, Saxne T, Geborek P, et al. Treatment with belimumab in systemic lupus erythematosus does not impair antibody response to 13-valent pneumococcal conjugate vaccine. Lupus. 2017;26(10):1072-1081.

   

Please click the Prescribing Information link to view the safety and adverse events information of Prevenar 13®.
For the use only of Registered Medical Practitioners or a Hospital or a Laboratory.

   

PP-PRV-IND-0268 July 2022

PCV13 in Rheumatology

Dosing

Help protect your adult patients against pneumococcal pneumonia with single-dose administration

Learn more

   

Efficacy

Efficacy proven by the CAPiTA study

Learn more

   

Recommendations for Use

The ACIP recommends routine use of PCV13 among adults

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