Vaccine responses in ANCA associated vasculitis (AAV)

Disease - Vasculitis

Lead applicant - Dr Rona Smith

Organisation - Addenbrookes Hospital

Type of grant - Clinical Studies

Status of grant - Active

Amount of the original award - £29,3467.97

Start date - 1 June 2017

Reference - 21391

Public Summary

What are the aims of this research?

Vasculitis means inflammation of any of your blood vessels. It can cause a variety of different symptoms and problems. One type of vasculitis, called antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, also known as AAV, is successfully treated in some cases by a drug called rituximab. As this treatment leaves the immune system compromised, it is recommended that patients also receive vaccinations to protect against flu and pneumonia. The researchers aim to see whether rituximab is negatively affecting these vaccines, or whether a combination of vaccines would be better at reducing the risk of infection.

Why is this research important?

In some conditions, such as AAV, B-cells in the body produce harmful autoantibodies that attack the body's own tissues. Rituximab is an increasingly used and highly effective treatment for AAV as it works by removing these B cells. However, as these cells are an important part of the immune system it means that people who have been treated with rituximab are at an increased risk of infection, so vaccines against the influenza (flu) virus and pneumococcus bacterium (which causes pneumonia and meningitis) are recommended.

It is thought that rituximab may be preventing these vaccines from working effectively, leaving people at risk of infection. To test this, the researchers will compare people with AAV who have or have not received rituximab treatment, to see if there is any difference in the effectiveness of a pneumococcus vaccine. They will also assess whether a separate booster vaccine, given six months later, improves the effectiveness of vaccination against pneumococcus bacteria.

How will the findings benefit patients?

Results from this research will help to inform clinicians about the administration of vaccines in people with AAV who have had rituximab treatment. If responses to these vaccines can be improved, then patients who receive rituximab treatment will be at a reduced risk of infection.