#3-45E. Blunted Immunity: RZV Responses in Abatacept Users (AnnRheumDis, 2026)

Prevention of herpes zoster is a critical unmet need in rheumatology, particularly for patients on immunosuppressive therapies. This episode explores a significant 2026 pilot randomized controlled trial investigating the safety and immunogenicity of the recombinant zoster vaccine (RZV) in rheumatoid arthritis patients actively treated with abatacept. While the study demonstrated that RZV was safe and did not increase the risk of disease flares, the immunological findings were concerning: the vaccine response was markedly attenuated. Specifically, less than half of the participants achieved a significant humoral response, and only about 10% mounted a cell-mediated immune response, which is crucial for viral protection. Listeners must weigh these findings against the study's limitations, primarily its small sample size of 70 participants which limits generalizability. Nevertheless, for clinicians, this paper is vital as it suggests that standard vaccination while on abatacept provides insufficient protection, highlighting the urgent need to investigate alternative strategies, such as withholding therapy around the time of vaccination, to ensure patient safety.

Citation: Hawkins JA, Curtis JR, Weinberg A, et al. Safety and immunogenicity of the recombinant zoster vaccine in patients with rheumatoid arthritis using abatacept: a pilot multicentre, double-blind, randomised controlled trial. Ann Rheum Dis. 2026. DOI: 10.1016/j.ard.2026.01.002

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.