Science from our Sisters

Meningococcal C Vaccine Safe and Effective for Juvenile Arthritis Patients

Vaccination against meningococcal serogroup C (MenC) does not aggravate juvenile idiopathic arthritis (JIA), nor is the vaccine inhibited by immunosuppressive therapies, according to a study published in Arthritis & Rheumatism (2007;56:639-646).

For this multicenter cohort study, researchers followed 234 patients age one to 19 for six months before and six months after vaccination, with patients serving as their own controls. No significant increase in disease activity was seen in the six months after vaccination when compared with the six months preceding. Furthermore, a subgroup of 166 patients did not experience more relapses after vaccination—in fact, the relapse risk in the month after vaccination was smaller than in the other 11 months studied.

The group of patients had a strong immune response to the vaccine, with the average anti-MenC IgG geometric mean concentration increasing from 0.4 µg/ml before vaccination to 28.9 µg/ml after vaccination. This increase is similar to that seen in healthy children given the vaccine.

Some patients taking disease-modifying anti-rheumatic drugs, methotrexate, tumor necrosis factor-a blockers, and prednisone had reduced responses to the vaccine, but even these patients demonstrated adequate protection in a serum bactericidal antibody titer test.

“Patients with JIA can be vaccinated safely and effectively with the MenC conjugate,” wrote lead author Evelien Zonneveld-Huijssoon, MD, Wilhelmina Children’s Hospital at the University Medical Center Utrecht in The Netherlands, and colleagues. This was true even for patients receiving highly immunosuppressive medication.

National Look at Arthritis-related Work Disability

Almost a third of Americans with physician-diagnosed arthritis—about 6.8 million people—report that their condition affects their ability to work, according to a study published in Arthritis Care & Research (2007; 57(3):355-363).

For the study, the investigators analyzed data of 31,044 individuals between age 18 and 64 who completed the 2002 National Health Interview Survey (NHIS).

People with recurrent pain or an unknown income were more likely to report work limitations associated with arthritis, as were African Americans and Hispanics. Women, people with good or excellent health, and individuals with a college degree or income more than $20,000 reported arthritis significantly less frequently.

In contrast to some previous research, level of education—except for a college degree—did not correlate with arthritis disability, nor did insurance status.

The authors note several limitations to the study. The self-reported results are subject to the limitations of the respondent’s recall, and, in cases with multiple comorbidities, it can be difficult to identify the source of the disability. Furthermore, the NHIS did not distinguish between people unable to work because of arthritis and those whose work was limited by the condition, and the survey data provide no insight into whether the arthritis preceded the work limitations.

Lead author Kristina Theis, MPH, a researcher at the Arthritis Program of the Centers for Disease Control and Prevention, and colleagues suggest several directions for further research: “What work are people with arthritis unable to do? Which groups are more affected and why? How can interventions for these groups be tested, targeted, delivered?”

Considering the effect work limitations due to arthritis have on the workforce and the economy, this study highlights a need for ways to manage or prevent arthritis-attributable work limitations, the authors note.

“Concurrently, the role of early diagnosis and appropriate medical and self-management remains strong, as does the role of public health in educating individuals with arthritis and AAWL and in promoting appropriate self-management,” they write.