Auto-immunity in Lupus Patients After Influenza Vaccine

NCT ID: NCT01072734

Last Updated: 2010-10-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-09-30

Study Completion Date

2010-02-28

Brief Summary

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Annual influenza vaccination is recommended in patients with systemic lupus erythematosus (SLE). However some concerns remain about vaccination and the risk of lupus flare

Detailed Description

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SLE is a chronic autoimmune disease associated with the production of pathogenic anti-nuclear autoantibodies (ANAs) and characterized by the loss of self tolerance and the overexpression of B cells, leading to a high immunoglobulin production, 90% being autoantibodies.

There have been concerns about the safety of vaccination in patients with autoimmune diseases as it has been hypothesised that stimulation of the immune system via vaccination may lead to an increase in disease activity. Furthermore, SLE patients display a variety of immune dysfunctions which may influence their response to influenza vaccination.

Studies indicate that, although influenza vaccination in SLE may generate autoimmune phenomena, no clinically significant increase in SLE disease activity can be expected. Therefore, influenza vaccination can be considered safe in quiescent SLE, in accordance with previous reviews on this subject

The aim of this study is to evaluate if the level of CXCR4 on leucocytes of patients with SLE could be a good prognostic marker for the efficacy and the safety of influenza vaccine in SLE patients. For that purpose, we will assay in lupus patients the cellular level of CXCR4 before and after administration of influenza vaccine and correlate the expression levels of CXCR4 with: 1) the evolution of clinical and biological signs of autoimmunity and 2) the humoral immune response towards influenza. If influenza vaccine has not been associated so far with increased risk of lupus flare, it is important to determine if patients with elevated leucocytes levels of CXCR4, (due to the impact of this molecule in humoral immunity), are more at risk of vaccine side effects particularly of autoimmune origin.

Conditions

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Systemic Lupus Erythematosus (SLE)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Vaccine group

single group: all included patients will receive the vaccine

Group Type EXPERIMENTAL

Vaccine

Intervention Type DRUG

Influenza vaccine

Interventions

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Vaccine

Influenza vaccine

Intervention Type DRUG

Other Intervention Names

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Influenza vaccine

Eligibility Criteria

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Inclusion Criteria

* 18 years of age and older
* informed consent signed
* LES patients who meet the American College of Rheumatology (ACR) diagnostic criteria of SLE
* Patient able to attend all visit schedule during the month following influenza vaccine administration
* Clinical examination performed prior final inclusion with results communicated to the patient

Exclusion Criteria

* For women, being pregnant or positive pregnancy test
* Positive for HCV, HIV and HBV
* Patient treated with rituximab (anti-CD20) or stopped for less than a year.
* Patient for whom a treatment majorization is suspected within the month following influenza vaccine administration.
* Hypersensitivity to active substances, eggs and to one of the vaccine components
* Other vaccinations within the last 30 days before the inclusion at J0
* Administration of blood products such as immunoglobulins within the last 90 days before J0
* Progressive cancer, cirrhoses
* Acute severe illness within the last 30 days before inclusion at J0
* Patient non affiliated to a health social security system
* Planned participation to another clinical study during the present study period
* patient deprived of freedom by an administrative or court order
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role collaborator

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Department Clinical Reseach of Developpement

Principal Investigators

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Odile Launay, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

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CIC Vaccinologie Hopital Cochin

Paris, , France

Site Status

Countries

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France

References

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Launay O, Paul S, Servettaz A, Roguet G, Rozenberg F, Lucht F, Lambert C, Presles E, Goulvestre C, Meritet JF, Galtier F, Dubray C, Lebon P, Weill B, Batteux F. Control of humoral immunity and auto-immunity by the CXCR4/CXCL12 axis in lupus patients following influenza vaccine. Vaccine. 2013 Aug 2;31(35):3492-501. doi: 10.1016/j.vaccine.2013.05.095. Epub 2013 Jun 11.

Reference Type DERIVED
PMID: 23764537 (View on PubMed)

Other Identifiers

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P090104

Identifier Type: -

Identifier Source: org_study_id